风心病瓣膜置换手术前猝死（5例报告及文献复习）

Sudden Cardiac Death of Rheumatic Heart Disease Patient before Prosthesis Replacement (A Report of 5 Cases and Review of Literatures)

风心病瓣膜置换手术前猝死是一个严重的临床问题，尚未见报告。作者报告５例已完成术前准备，即将手术置换瓣膜的患者发生猝死。这些患者的特点是：心功Ⅳ级，有主动脉瓣关闭不全和左室肥厚。猝死多在卧床及夜间发生，且无急性左心衰和低血钾。结合文献复习，作者对精神紧张与猝死的关系，发生机理及可能的对策进行了讨论。

No report of such sudden cardiac doath have been found in the literatures. Five cases of sudden cardiac death are reported in which operative preparation have been finished and valve replacement would be carried out with prostnesis. The features of these cases are NYHA IV degree, aortic valve regurgitation and left ventricular hypertrophy, The sudden cardiac death almost occured during the nocturnal period and bed rest, without acute left ventricular failure and hypokalemia. In combination with literature review, the relationship between mental stress and sudden cardiac death, mechanisms and possible treatment are discussed.