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蜂蜇伤后心肌梗死。附病例报告及文献复习

[Myocardial infarction following a bee sting. Apropos of a case and review of the literature].

作者信息

Massing J L, Bentz M H, Schlesser P, Dumitru C, Louis J P

机构信息

Service de Cardiologie, Centre Hospitalier Général Montbéliard.

出版信息

Ann Cardiol Angeiol (Paris). 1997 May-Jun;46(5-6):311-5.

PMID:9295891
Abstract

The authors report a case of limited inferior myocardial infarction in a young man following a bee sting. Coronary angiography, performed following the acute phase, showed angiographically healthy coronary arteries and minimal sequelae of myocardial necrosis in the inferior territory. The pathogenic role of the bee sting in myocardial necrosis was suggested by the timing of the events. The probable mechanism responsible for this myocardial infarction was severe coronary arterial spasm (partly mediated by psychological stress related to the intensity of the anaphylactic reaction) with secondary in situ thrombosis probably facilitated by cardiovascular collapse. The role of anaphylaxis, generating acute coronary insufficiency, is discussed in the light of this clinical case.

摘要

作者报告了一例年轻男性在被蜜蜂蜇伤后发生局限性下壁心肌梗死的病例。急性期过后进行的冠状动脉造影显示,冠状动脉造影显示冠状动脉血管造影正常,下壁心肌坏死的后遗症轻微。事件发生的时间提示了蜜蜂蜇伤在心肌坏死中的致病作用。导致此次心肌梗死的可能机制是严重的冠状动脉痉挛(部分由与过敏反应强度相关的心理压力介导),继发原位血栓形成,可能因心血管衰竭而加剧。根据该临床病例讨论了过敏反应导致急性冠状动脉供血不足的作用。

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