妊娠合并重症暴发性心肌炎1例报道并文献复习

A case report of fulminant myocarditis in a pregnant woman and literature review

患者32岁,女性,因“G3P1,停经30+6周,发热伴心悸2 d”入院。血肌钙蛋白1.356μg/L(↑)、肌酸激酶同工酶10.4μg/L(↑),心电图示窦性心动过速(心率112次/min),ST段抬高(Ⅱ、Ⅲ、aVF、V3~V6 J点上移型)。患者1个月前曾有“感冒”病史。经多学科会诊后,予连续肾脏替代疗法、体外膜肺氧合机械循环支持。病情平稳后全身麻醉下行剖宫取胎术,后患者顺利出院。妊娠合并重症暴发性心肌炎的报道较少,该病例的临床资料及处理办法可为临床诊治提供参考。

A 32-year-old patient(G3P1)was admitted to the hospital due to“fever accompanied by heart palpitations for 2 d”after 30+6 gestational weeks.Serum troponin I(cTnI)was 1.356μg/L(↑),and creatine kinase MB(CK-MB)was 10.4μg/L(↑).Electrocardiogram showed sinus tachycardia(heart rate 112 beats/min),and ST segment elevation(Ⅱ,Ⅲ,aVF and V3-V6 J point upward shift type).The patient had a history of"cold"1 month ago.Among the multidisciplinary consultation,continuous renal replacement therapy and extracorporeal membrane oxygenation mechanical circulation support followed up.The patient was given caesarean section under general anesthesia after stable condition.After that,the patient was discharged from the hospital.There are few reports on pregnancy combined with fulminant myocarditis.The clinical data and treatment of this case can provide reference for clinicians.