Nag Deb Sanjay, Chatterjee Abhishek, Mahanty Pratap Rudra, Sam Merina, Bharadwaj Murari Kumar
Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, India.
Department of Anaesthesiology, Manipal Tata Medical College, Jamshedpur 831017, India.
World J Clin Cases. 2024 May 6;12(13):2147-2150. doi: 10.12998/wjcc.v12.i13.2147.
Myasthenia gravis (MG) is an autoimmune disorder that affects the neuromuscular junction. The primary pathology in MG involves the presence of autoantibodies to acetylcholine receptors (AChRs), which results in qualitative and quantitative reductions in the availability of functional AChRs. Cardiac muscles are also affected, resulting in various perioperative cardiac complications. Antistriational antibodies are commonly reported in MG cases with cardiac involvement. In the presence of thymoma, the prevalence of cardiac manifestations in patients with MG increases to approximately 10%-15%. Cardiac involvement in MG may range from asymptomatic electrocardiogram changes to ventricular tachycardia, myocarditis, conduction disorders, heart failure, and sudden death. Increased incidence of atrial fibrillation, ventricular and supraventricular extra systoles, and prolonged QTc have also been reported in patients with MG. Clinicians should consider the evaluation of autonomic dysfunction and risk of cardiovascular disease in patients with MG.
重症肌无力（MG）是一种影响神经肌肉接头的自身免疫性疾病。MG的主要病理变化包括存在抗乙酰胆碱受体（AChR）自身抗体，这导致功能性AChR的数量和质量减少。心肌也会受到影响，从而导致各种围手术期心脏并发症。抗横纹肌抗体在合并心脏受累的MG病例中较为常见。在存在胸腺瘤的情况下，MG患者心脏表现的发生率增加至约10%-15%。MG的心脏受累范围可从无症状心电图改变到室性心动过速、心肌炎、传导障碍、心力衰竭和猝死。MG患者还报告有房颤、室性和室上性早搏发生率增加以及QTc延长。临床医生应考虑对MG患者进行自主神经功能障碍评估和心血管疾病风险评估。
