Ota Hisanobu, Kawamura Yuichiro, Sato Nobuyuki, Hasebe Naoyuki
Department of Cardiology, Hakodate Watanabe Hospital, Japan.
Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical University, Japan.
Intern Med. 2017;56(22):3047-3050. doi: 10.2169/internalmedicine.8875-17. Epub 2017 Nov 15.
We report the case of a 61-year-old man with schizophrenia who was treated with carbamazepine, in whom electrocardiography showed transient Brugada-type ST elevation. He had been hospitalized our hospital's Department of Psychiatry and had been diagnosed with pneumonia. On the following day, electrocardiography showed coved-type ST elevation in the right precordial leads and a blood examination revealed that the patient's carbamazepine concentration was at the upper limit of the standard range, as well as hypothyroidism. The patient's electrocardiogram normalized after the withdrawal of carbamazepine. We demonstrated that the patient's carbamazepine concentration-and not hypothyroidism-was associated with the serial electrocardiographic changes by monitoring the patient's blood concentration of carbamazepine and his thyroid function.
我们报告了一例61岁的精神分裂症男性患者,该患者接受卡马西平治疗,其心电图显示短暂性Brugada型ST段抬高。他曾入住我院精神科,被诊断为肺炎。次日,心电图显示右胸前导联出现穹窿型ST段抬高,血液检查显示患者的卡马西平浓度处于标准范围上限,同时存在甲状腺功能减退。停用卡马西平后患者的心电图恢复正常。通过监测患者的卡马西平血药浓度及其甲状腺功能,我们证明了患者的心电图系列变化与卡马西平浓度有关,而非甲状腺功能减退。