Inoue Wataru, Motoki Hirohiko, Yoshie Koji, Kuwahara Koichiro
Department of Cardiovascular Medicine, Shinshu University School of Medicine, Japan.
Intern Med. 2024;63(5):681-686. doi: 10.2169/internalmedicine.1673-23.
A 25-year-old woman with left ventricular (LV) dysfunction became pregnant during the diagnostic period. Decompensated heart failure with frequent ventricular arrhythmias necessitated hospitalization in the 21st week of pregnancy. Under careful monitoring, diuretics and sotalol were added to her ongoing treatment of carvedilol and spironolactone due to the risk of hemodynamic collapse. An emergency cesarean section was performed in the 32nd week after the detection of rapid nonsustained ventricular tachycardia. Subsequent genetic testing revealed that the LV dysfunction was associated with Danon cardiomyopathy. This case highlights the importance of careful pregnancy management with LV dysfunction along with early genetic testing.
一名25岁左心室功能不全的女性在诊断期间怀孕。妊娠21周时,失代偿性心力衰竭伴频发室性心律失常,需要住院治疗。由于存在血流动力学崩溃的风险,在仔细监测下,除了她正在服用的卡维地洛和螺内酯外,还加用了利尿剂和索他洛尔。在检测到快速非持续性室性心动过速后,于第32周进行了紧急剖宫产。随后的基因检测显示,左心室功能不全与丹农心肌病有关。该病例强调了对左心室功能不全患者进行仔细的妊娠管理以及早期基因检测的重要性。