一例维拉帕米中毒导致梗阻性肥厚型心肌病血流动力学受损的病例报告。
A case report of verapamil toxicity leading to haemodynamic compromise in obstructive hypertrophic cardiomyopathy.
作者信息
Gau Jonathan W, Rader Florian, Mody Behram, Lee Andy Y
机构信息
Department of Internal Medicine, School of Medicine, University of California, Irvine, 101 City Dr S, Orange, CA 92868, USA.
Department of Cardiology, Cedars-Sinai Medical Center, Smidt Heart Institute, 127 S San Vicente Blvd Pavilion Suite A3600, Los Angeles, CA 90048, USA.
出版信息
Eur Heart J Case Rep. 2024 Nov 20;8(12):ytae596. doi: 10.1093/ehjcr/ytae596. eCollection 2024 Dec.
BACKGROUND
Hypertrophic cardiomyopathy (HCM) is an inherited condition characterized by left ventricular (LV) hypertrophy unexplained by increased afterload, often with concomitant outflow tract obstruction. Verapamil is commonly used to treat symptomatic patients. However, its potential for adverse effects should be recognized.
CASE SUMMARY
This report provides a case of cardiogenic shock in HCM, where a patient presented with chief complaint of fatigue and shortness of breath with an acute decline in LV systolic function on echocardiogram. His symptoms were attributed to verapamil toxicity following a recent increase in dosage. He achieved rapid symptom relief after holding his home medications, in addition to conservative management.
DISCUSSION
This case report aims to elucidate the potential for multiple adverse effects involved with verapamil use in patients with obstructive HCM.
背景
肥厚型心肌病（HCM）是一种遗传性疾病，其特征为左心室（LV）肥厚，且不能用后负荷增加来解释，常伴有流出道梗阻。维拉帕米常用于治疗有症状的患者。然而，应认识到其潜在的不良反应。
病例摘要
本报告提供了一例HCM患者发生心源性休克的病例，该患者的主要症状为疲劳和呼吸急促，超声心动图显示左心室收缩功能急性下降。其症状归因于近期增加剂量后出现的维拉帕米毒性。除了保守治疗外，他在停用家庭用药后症状迅速缓解。
讨论
本病例报告旨在阐明梗阻性HCM患者使用维拉帕米可能产生的多种不良反应。
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