McDonald Abigail
Internal Medicine, HCA Healthcare/USF Morsani College of Medicine GME Programs, Northside Hospital, St. Petersburg, USA.
Cureus. 2020 Apr 15;12(4):e7680. doi: 10.7759/cureus.7680.
This is the case of a 92-year-old female who was hospitalized one month prior to admission for symptomatic paroxysmal atrial fibrillation, requiring intravenous amiodarone. Following her previous admission, she was placed on one month of amiodarone 200 mg twice daily, with a one week transition to 200 mg daily. The patient subsequently developed progressive shortness of breath and dry cough over a period of several weeks. Initial imaging showed diffuse bilateral coarse patchy interstitial infiltration on chest X-ray and bibasilar pleural effusions and scattered bilateral opacities on CTA chest. In an elderly patient presenting with dyspnea and dry cough, as well as interstitial opacities on imaging, amiodarone pulmonary toxicity should be considered despite short-term low-dose use.
这是一位92岁女性的病例,她在入院前一个月因症状性阵发性心房颤动住院,需要静脉注射胺碘酮。上次入院后,她服用了一个月的胺碘酮,每日两次,每次200毫克,随后一周逐渐减量至每日200毫克。此后数周内,患者逐渐出现进行性气短和干咳。初步影像学检查显示,胸部X线片上有弥漫性双侧粗颗粒状斑片状间质浸润,胸部CTA显示双侧基底胸膜腔积液及双侧散在混浊影。对于出现呼吸困难、干咳以及影像学检查显示间质混浊的老年患者,尽管使用的是短期小剂量胺碘酮,也应考虑胺碘酮所致的肺毒性。