脊柱矫正手术后并发漏斗胸的严重应激性心肌病：一例报告。
Severe stress cardiomyopathy following spinal corrective surgery for scoliosis complicated with pectus excavatum: a case report.
机构信息
Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, China.
Department of Anesthesiology, Nanjing Drum Tower Hospital, The affiliated hospital of Nanjing University Medical School, Nanjing, 210008, China.
出版信息
BMC Anesthesiol. 2024 Sep 18;24(1):333. doi: 10.1186/s12871-024-02713-4.
BACKGROUND
Stress cardiomyopathy (SCM) is an acute heart failure syndrome characterized by transient, usually reversible left ventricular systolic dysfunction with normal or enhanced basal compensatory wall motion abnormalities involving the left ventricular anterior septum and apex, resulting in a "ballooning" appearance. However, it has rarely been reported in patients undergoing spinal surgery.
CASE PRESENTATION
We report a case of severe stress cardiomyopathy in a scoliosis patient with pectus excavatum who underwent spinal corrective surgery. During the wake-up period, circulatory collapse occurred. After multidisciplinary consultation, the patient was diagnosed with stress cardiomyopathy. At last, she had a good prognosis after a series of treatments including ECMO.
CONCLUSION
Stress cardiomyopathy is a reversible but uncommon condition. It can cause death if it is not diagnosed in time. Consequently, this report should improve the awareness of orthopedists and anesthesiologists for timely identification and management. For patients with potential risk factors, timely preoperative intervention should be performed to reduce the occurrence of stress cardiomyopathy.
背景
应激性心肌病（SCM）是一种以短暂、通常为可逆性左心室收缩功能障碍为特征的急性心力衰竭综合征，伴有正常或增强的基底代偿性室壁运动异常，累及左心室前间隔和心尖，呈现“气球样”外观。然而，在接受脊柱手术的患者中，这种情况很少见。
病例介绍
我们报告了一例患有漏斗胸的脊柱侧弯患者在接受脊柱矫形手术后发生严重应激性心肌病的病例。在唤醒期间，患者发生了循环衰竭。经过多学科会诊，患者被诊断为应激性心肌病。最后，经过一系列治疗，包括体外膜肺氧合（ECMO），患者预后良好。
结论
应激性心肌病是一种可逆但不常见的疾病。如果不能及时诊断，它可能导致死亡。因此，本报告应提高矫形外科医生和麻醉师的认识，以便及时识别和管理。对于有潜在风险因素的患者，应及时进行术前干预，以降低应激性心肌病的发生。
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