Zhang Jia, Zou Yingying, Chen Xiaoshu, Pan Jingye, Yu Haizhu, Wang Yi, Wu Yanran, Zou He
Department of Inspection Medical, Wenzhou People's Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, China.
Digestive System Department, The Third Affiliated Hospital of Qiqihar Medical College, Qiqihar, China.
SAGE Open Med Case Rep. 2023 Jan 3;11:2050313X221147194. doi: 10.1177/2050313X221147194. eCollection 2023.
Acquired long QT syndrome caused by hypopituitarism and transient ST-segment elevation has not been reported in cardiac arrest patients. We report a case of extremely dangerous acquired long QT syndrome and transient ST-segment elevation. A 44-year-old Chinese woman with renal failure experienced sudden cardiac arrest in the haemodialysis room. Subsequent electrocardiogram showed QT prolongation and transient ST-segment elevation. This patient's medical history, subsequent laboratory results and pituitary magnetic resonance imaging suggested hypopituitarism. Transient ST-segment elevation on the electrocardiogram was considered to be caused by repeated direct current shocks. The patient was diagnosed with acquired long QT syndrome and was not taking any antiarrhythmic drugs. Her corrected QT interval normalized after hormone replacement therapy. This case highlights the importance of the awareness of hypopituitarism; early identification and intervention can prevent the occurrence of this life-threatening arrhythmia. ST-segment elevation is not always due to acute myocardial infarction, and a variety of other causes, especially electrical cardioversion, should be considered.
垂体功能减退症所致获得性长QT综合征及短暂性ST段抬高在心脏骤停患者中尚未见报道。我们报告一例极其危险的获得性长QT综合征及短暂性ST段抬高病例。一名44岁患有肾衰竭的中国女性在血液透析室发生心脏骤停。随后的心电图显示QT间期延长及短暂性ST段抬高。该患者的病史、后续实验室检查结果及垂体磁共振成像提示垂体功能减退症。心电图上的短暂性ST段抬高被认为是由反复直流电电击所致。该患者被诊断为获得性长QT综合征，且未服用任何抗心律失常药物。激素替代治疗后其校正QT间期恢复正常。该病例突出了认识垂体功能减退症的重要性；早期识别和干预可预防这种危及生命的心律失常的发生。ST段抬高并非总是由急性心肌梗死所致，应考虑多种其他原因，尤其是电复律。
