应激性心肌病1例分析

A case report of stress cardiomyopathy

休克在重症患者中是很常见的,以往认为心源性休克多源自于急性冠状动脉事件,同时,感染性休克患者也可合并心肌抑顿,导致心源性休克。上述两种情况一旦出现,往往预后不良,但2007年初我们收治了1例心源性休克的患者,并不是由于急性心肌梗死或严重感染等情况所致,更富有戏剧性的是经过支持治疗,该患者的心脏功能在短期内完全恢复。经过文献回顾我们认为,患者应考虑合并了应激性心肌病,该疾病在重症医学领域少有报道,但由于此类患者的心脏功能经过积极干预可在短期内痊愈,此点不同于其他原因引起的心源性休克,故我们应提高对应激性心肌病的认识,早期诊断、积极干预,争取患者的良好预后。

Shock is very common in critical illness patients. People usually consider that cardiogenic shock derived from acute coronary arteries accident and myocardial stun due to severe sepsis. Once this kind of condition occurs, the outcome will become very bad. Recently, cardiac function of one patient who have cardiogenic shock induced by neither any myocardial infarction nor severe sepsis recovers by supportive treatment. We consider that this patient suffers from the disease named of stress cardiomyopathy. Few cases with critical illness were reported. The heart completely recovers within a couple of weeks, which is completely different from what is seen with acute coronal artery accident. To improve cognition, timely diagnosis and proper intervention is beneficial to the improvement of outcome.