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特发性冠状动脉痉挛导致反复心脏骤停和完全性房室传导阻滞:一例报告

Recurrent cardiac arrest and complete atrioventricular block due to idiopathic coronary vasospasm: A case report.

作者信息

Gao Wei, Liu Yingwu, Li Tong

机构信息

Department of Heart Center, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin, 300170, China.

Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, China.

出版信息

Heliyon. 2023 Dec 16;10(1):e23766. doi: 10.1016/j.heliyon.2023.e23766. eCollection 2024 Jan 15.

Abstract

Recurrent complete atrioventricular block induced by coronary spasm is rare. We present a case of a 47-year-old woman who suffered from two episodes of out-of-hospital cardiac arrest within one year due to complete atrioventricular block caused by coronary vasospasm. No implantable cardioverter defibrillator was implanted after her first episode. As for the second episode, permanent brain injury was left behind despite successful cardiopulmonary resuscitation. She underwent a challenging rehabilitation process and an implantable cardioverter defibrillator was implanted before discharge. We captured the dynamic changes of the electrocardiogram during the episode with high temporal resolution. This case illustrates the importance of recognizing coronary spasm as a potential cause of complete atrioventricular block and highlights the need for implantable cardioverter defibrillator in such patients to improve survival and quality of life.

摘要

冠状动脉痉挛诱发的反复性完全性房室传导阻滞较为罕见。我们报告一例47岁女性,她在一年内因冠状动脉血管痉挛导致的完全性房室传导阻滞而发生两次院外心脏骤停。首次发作后未植入植入式心脏复律除颤器。至于第二次发作,尽管心肺复苏成功,但仍遗留永久性脑损伤。她经历了具有挑战性的康复过程,并在出院前植入了植入式心脏复律除颤器。我们以高时间分辨率捕捉了发作期间心电图的动态变化。该病例说明了认识到冠状动脉痉挛是完全性房室传导阻滞潜在病因的重要性,并强调了在此类患者中植入植入式心脏复律除颤器以提高生存率和生活质量的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0be8/10777016/341f3e1b8184/gr1.jpg

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