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阵发性室上性心动过速与心脏骤停:一例以肺栓塞伴梗死为长期新冠综合征后遗症的病例报告

Paroxysmal Supraventricular Tachycardia and Cardiac Arrest: A Presentation of Pulmonary Embolism With Infarction as a Sequela of Long COVID Syndrome.

作者信息

Talwar Dhruv, Kumar Sunil, Acharya Sourya, Khanna Shivam, Hulkoti Vidyashree

机构信息

Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND.

出版信息

Cureus. 2021 Oct 7;13(10):e18572. doi: 10.7759/cureus.18572. eCollection 2021 Oct.

Abstract

With the emergence of diverse post-COVID sequelae, there have been reports of thromboembolic events such as stroke, myocardial infarction, and pulmonary embolism. These events have been reported after severe coronavirus disease 2019 (COVID-19) infections mostly requiring intensive care unit admissions. The findings of acute pulmonary embolism on electrocardiography are commonly sinus tachycardia and S1Q3T3. However, the presentation of pulmonary embolism with arrhythmias is rare. We report a case of a young 31-year-old female who had a history of COVID-19 with a chest computed tomography (CT) severity score of 5/25 five weeks back and presented with acute onset chest pain, breathlessness for one hour followed by collapse. She was intubated in the emergency department and managed with antiarrhythmic drugs however she went into sudden cardiorespiratory arrest and was revived with cardiopulmonary resuscitation. The patient was finally diagnosed as a case of pulmonary embolism leading to pulmonary infarction presenting as paroxysmal supraventricular tachycardia and cardiac arrest as a result of long COVID syndrome. This emphasizes the importance of routine follow-up and strict vigilance even in young patients with mild COVID-19 as it might result in serious life-threatening complications which otherwise seem to be unexpected.

摘要

随着新冠后遗症的出现,已有关于血栓栓塞事件的报道,如中风、心肌梗死和肺栓塞。这些事件大多发生在严重的2019冠状病毒病(COVID-19)感染后,通常需要入住重症监护病房。急性肺栓塞在心电图上的表现通常为窦性心动过速和S1Q3T3。然而,伴有心律失常的肺栓塞表现较为罕见。我们报告一例31岁年轻女性病例,该患者有COVID-19病史,五周前胸部计算机断层扫描(CT)严重程度评分为5/25,出现急性胸痛、呼吸困难1小时,随后晕倒。她在急诊科接受了插管治疗,并使用抗心律失常药物进行处理,但她突然发生心肺骤停,经心肺复苏后恢复。该患者最终被诊断为肺栓塞导致肺梗死,表现为阵发性室上性心动过速和心脏骤停,是由长期新冠综合征引起的。这强调了即使是轻度COVID-19的年轻患者也需要进行常规随访和严格监测的重要性,因为这可能会导致严重的危及生命的并发症,而这些并发症在其他情况下似乎是意想不到的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7356/8575334/bf16c427c265/cureus-0013-00000018572-i01.jpg

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