Cerisier A, Dacosta A, Dubois F, Guy J M, Lamaud M, Verneyre H
Service de cardiologie, CHU Nord, Saint-Etienne.
Arch Mal Coeur Vaiss. 1995 Apr;88(4):521-3.
The authors report the case of myocardial infarction occurring immediately after rapid intravenous infusion of a high dose of corticosteroids prescribed for a relapse of multiple sclerosis. Ventriculography confirmed the myocardial damage but the coronary arteries were normal. An aetiological investigation was negative. The authors review the cardiac secondary effects which may be very serious and even fatal. Coronary insufficiency is rare (only 3 previously published cases); it is therefore difficult to determine the prognosis. The possible mechanisms of infarction are discussed. Finally, the authors underline the importance of recording an ECG before treatment, of ECG monitoring during the infusion, and the need for repeating the recordings and of prolonging hospital admission when necessary.
作者报告了1例在快速静脉输注大剂量皮质类固醇激素治疗多发性硬化症复发后立即发生心肌梗死的病例。心室造影证实了心肌损伤，但冠状动脉正常。病因学调查结果为阴性。作者回顾了可能非常严重甚至致命的心脏继发性效应。冠状动脉供血不足很罕见（此前仅发表过3例）；因此，很难确定预后。文中讨论了梗死的可能机制。最后，作者强调了治疗前记录心电图、输注过程中进行心电图监测的重要性，以及重复记录和必要时延长住院时间的必要性。
