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竹叶青蛇咬伤后无胸痛的急性心肌梗死:一例报告

Acute myocardial infarction with no chest pain following a Trimeresurus stejnegeri snakebite: a case report.

作者信息

Li He, Li Yiyi, Wu Xianrong

机构信息

Department of Emergency Medicine, Yulin First People's Hospital (The Sixth Affiliated Hospital of Guangxi Medical University) Yulin 537000, Guangxi Zhuang Autonomous Region, China.

Department of Cardiology, Yulin First People's Hospital (The Sixth Affiliated Hospital of Guangxi Medical University) Yulin 537000, Guangxi Zhuang Autonomous Region, China.

出版信息

Am J Transl Res. 2022 Jun 15;14(6):4169-4175. eCollection 2022.

Abstract

A 74-year-old female was bitten by a Trimeresurus stejnegeri, which is an unusual but dangerous type of snakebite. After the snakebite, the patient developed oedema, pain and numbness in the injured limb, and acute myocardial infarction, but no chest pain. The patient received base treatment, including anti-venom serum, statins and wound cleaning. After treatment, the pain in the injured limb disappeared and the swelling decreased. The patient underwent a coronary angiogram the next day, and severe stenosis of the anterior descending branch of the left coronary artery was found. She was given coronary stent implantation. After surgery, she was treated with anticoagulants, and antiplatelet medication and was discharged from the hospital on the sixth day after the condition improved. This case report of myocardial infarction-related snake envenomation aims to increase the awareness that snakebites may cause AMI and therefore, multidisciplinary management particularly from emergency physicians and cardiologists may be necessary.

摘要

一名74岁女性被竹叶青蛇咬伤,这是一种不常见但危险的蛇咬伤类型。蛇咬伤后,患者受伤肢体出现水肿、疼痛和麻木,并发生急性心肌梗死,但无胸痛症状。患者接受了包括抗蛇毒血清、他汀类药物和伤口清洗在内的基础治疗。治疗后,受伤肢体疼痛消失,肿胀减轻。患者于次日接受冠状动脉造影,发现左冠状动脉前降支严重狭窄。她接受了冠状动脉支架植入术。术后,她接受了抗凝和抗血小板药物治疗,病情好转后第六天出院。这份关于与心肌梗死相关的蛇咬伤病例报告旨在提高人们对蛇咬伤可能导致急性心肌梗死的认识,因此,可能需要多学科管理,尤其是急诊医生和心脏病专家的参与。

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本文引用的文献

1
Current Knowledge on Snake Dry Bites.蛇干咬伤的现有知识。
Toxins (Basel). 2020 Oct 22;12(11):668. doi: 10.3390/toxins12110668.
4
Snakebite envenoming.蛇伤中毒。
Nat Rev Dis Primers. 2017 Sep 14;3:17063. doi: 10.1038/nrdp.2017.63.

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