Terradellas J B, Bellot J F, Sarís A B, Gil C L, Torrallardona A T, Garriga J R
Chest. 1982 Apr;81(4):444-8. doi: 10.1378/chest.81.4.444.
Acute elevation of the ST segment in several ECG leads was observed in seven patients with bacterial shock during the course of therapy. Six patients had bacterial pneumonia, one had acute cholecystitis, and none had a previous history of heart disease. At the onset of the ST elevation, all patients were receiving dopamine infusion, which in four of them was inadvertently increased shortly before the ECG changes, the ST elevation was not associated with chest pain, pericardial friction rub, or acute changes in the heart rate, or arterial blood pressure. In four patients the maximum ST elevation was greater than or equal to 5 mm. In each instance the ST segment returned to the isoelectric line within 24 hours, and subsequent development of Q waves or changes in the QRS was not observed. Although the existence of an acute pericarditis or an acute myocarditis as possible causes of the ST elevation cannot be fully ruled out, the sudden onset, prominent magnitude, and brief duration of the ST elevation are perhaps more indicative of an acute ischemic event, possibly related to a transient coronary vasoconstriction induced by the dopamine infusion.
在7例感染性休克患者的治疗过程中，观察到多个心电图导联ST段急性抬高。6例患者患有细菌性肺炎，1例患有急性胆囊炎，均无心脏病史。ST段抬高发作时，所有患者均接受多巴胺输注，其中4例在心电图改变前不久无意中增加了多巴胺剂量，ST段抬高与胸痛、心包摩擦音、心率或动脉血压的急性变化无关。4例患者的最大ST段抬高≥5mm。在每种情况下，ST段均在24小时内恢复到等电位线，未观察到随后Q波的出现或QRS波群的变化。尽管不能完全排除急性心包炎或急性心肌炎作为ST段抬高的可能原因，但ST段抬高的突然发作、显著幅度和短暂持续时间可能更提示急性缺血事件，可能与多巴胺输注引起的短暂冠状动脉血管收缩有关。
