Ohnaga Yoshiyuki, Ono Ryohei, Aoki Kaoruko, Kato Hirotoshi, Iwahana Togo, Takaoka Hiroyuki, Omoto Akiko, Nakama Kaito, Kishimoto Takashi, Ikeda Jun-Ichiro, Kobayashi Yoshio
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan.
Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, Japan.
Intern Med. 2025 Apr 1;64(7):1047-1052. doi: 10.2169/internalmedicine.3501-24. Epub 2024 Sep 4.
Retained placenta can lead to septic shock; however, sepsis-induced cardiomyopathy (SICM) due to retained placenta has not been reported previously. This report presents a rare case of SICM following septic shock due to retained placenta after miscarriage in a 40-year-old woman, accompanied by the "shark fin sign" on an electrocardiogram, a pattern typically linked to myocardial ischemia. She experienced ventricular tachycardia and required venoarterial extracorporeal membrane oxygenation; however, she was successfully treated. We also reviewed previous cases of shark fin sign in patients without myocardial infarction. A review showed that half of the cases experienced lethal arrhythmias, even without myocardial infarction.
胎盘残留可导致感染性休克;然而,此前尚未有因胎盘残留导致脓毒症性心肌病(SICM)的报道。本报告介绍了一例罕见病例,一名40岁女性流产后因胎盘残留发生感染性休克,继而引发SICM,其心电图出现“鲨鱼鳍征”,这一模式通常与心肌缺血有关。她出现室性心动过速,需要进行静脉-动脉体外膜肺氧合治疗;不过,她最终成功治愈。我们还回顾了既往无心肌梗死患者出现鲨鱼鳍征的病例。回顾显示,即使没有心肌梗死,半数病例也发生了致命性心律失常。