Fitzpatrick A P, Dawkins K, Conway N
Wessex Cardiac Centre, Southampton General Hospital.
Br Heart J. 1993 May;69(5):453-4. doi: 10.1136/hrt.69.5.453.
A previously fit marathon-running 54 year old man was admitted as an emergency having collapsed with chest pain caused by an acute transmural anterior myocardial infarction. He was initially resuscitated by his general practitioner then had recurrent episodes of ventricular flutter and fibrillation requiring continuing cardiopulmonary resuscitation and repeated defibrillation. During ambulance transfer and in the hospital emergency department he received appropriate intravenous antiarrhythmic drug treatment and a total of 63 transthoracic DC shocks, with good cardiac output between shocks. After his condition failed to stabilise in intensive care, an intra-aortic balloon pump was inserted and coronary angiography showed a proximal occlusion of the left anterior descending branch. Coronary angioplasty successfully re-opened the vessel with an excellent angiographic result. The intra-aortic balloon pump was withdrawn the following day and he was well enough to be discharged 7 days later. At 4 weeks he performed a satisfactory maximal exercise test and remains in New York Heart Association functional class I.
一名既往健康的54岁马拉松运动员因急性透壁性前壁心肌梗死导致胸痛而晕倒，作为急诊入院。他最初由其全科医生进行了复苏，随后反复出现室性扑动和颤动，需要持续的心肺复苏和反复除颤。在救护车转运期间及医院急诊科，他接受了适当的静脉抗心律失常药物治疗，并总共接受了63次经胸直流电除颤，两次除颤之间心输出量良好。在重症监护室病情未能稳定后，插入了主动脉内球囊反搏泵，冠状动脉造影显示左前降支近端闭塞。冠状动脉成形术成功地重新开通了血管，血管造影结果极佳。次日撤出主动脉内球囊反搏泵，7天后他身体状况良好得以出院。4周时，他进行了一次令人满意的最大运动试验，目前仍处于纽约心脏协会心功能I级。
