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疑似新冠疫苗接种后心包炎/心肌炎患者行心包开窗术的麻醉管理:一例报告及文献综述

Anesthetic Management of Suspected COVID-19 Vaccination Pericarditis/Myocarditis Scheduled for a Pericardial Window: A Case Report and Literature Review.

作者信息

Karemingi Cecilia, Georgiyeva Kateryna, Santiesteban Elizabeth, Sciarra John, Kumar Harendra

机构信息

Anesthesiology, Larkin Community Hospital, South Miami, USA.

Anesthesiology, University of Rochester, Rochester, USA.

出版信息

Cureus. 2023 May 19;15(5):e39222. doi: 10.7759/cureus.39222. eCollection 2023 May.

Abstract

The unique challenges posed by the COVID vaccination continue to affect multiple healthcare specialties. Although short-term studies have shown that COVID-19 vaccines are both safe and effective, reports of side effects continue to emerge. Cardiovascular side effects such as myo-pericardial inflammation are of particular interest to the fields of cardiology, anesthesiology, and surgery. Myocarditis and pericarditis necessitate diagnostic and therapeutic procedures such as transesophageal echocardiography (TEE) and pericardial window surgery. Intraoperative monitoring of clinical status and heart rhythm and careful adjustments to anesthetic management are required to ensure successful outcomes. This case report follows a 50-year-old male with a known history of pericardial effusion post-COVID vaccination who presented to the emergency department with shortness of breath and chest pain, necessitating further management. We examine the importance of TEE in preventing unnecessary pericardial window procedures and shed light on the importance of careful patient monitoring and management in promoting successful outcomes from an anesthesiology perspective.

摘要

新冠疫苗接种带来的独特挑战持续影响着多个医疗专科。尽管短期研究表明新冠疫苗安全有效,但副作用报告仍不断出现。心肌炎心包炎等心血管副作用尤其受到心脏病学、麻醉学和外科领域的关注。心肌炎和心包炎需要经食管超声心动图(TEE)和心包开窗手术等诊断和治疗程序。术中需要监测临床状态和心律,并仔细调整麻醉管理以确保手术成功。本病例报告讲述了一名50岁男性,有新冠疫苗接种后心包积液病史,因呼吸急促和胸痛就诊于急诊科,需要进一步治疗。我们从麻醉学角度探讨了TEE在预防不必要的心包开窗手术中的重要性,并阐明了仔细监测和管理患者对于促进手术成功的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21cb/10276972/d4c229499d25/cureus-0015-00000039222-i01.jpg

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本文引用的文献

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