A case of fulminant myocarditis complicated by severe coronary spasm

DOI
  • Sato Yusuke
    Department of cardiovascular medicine, University of Fukui Hospital
  • Morishita Tetsuji
    Department of cardiovascular medicine, University of Fukui Hospital
  • Uzui Hiroyasu
    Department of cardiovascular medicine, University of Fukui Hospital
  • Arakawa Kenichiro
    Department of cardiovascular medicine, University of Fukui Hospital
  • Amaya Naoki
    Department of cardiovascular medicine, University of Fukui Hospital
  • Kaseno Kenichi
    Department of cardiovascular medicine, University of Fukui Hospital
  • Ishida Kentaro
    Department of cardiovascular medicine, University of Fukui Hospital
  • Sato Takehiko
    Department of cardiovascular medicine, University of Fukui Hospital
  • Fukuoka Yoshitomo
    Department of cardiovascular medicine, University of Fukui Hospital
  • Ikeda Hiroyuki
    Department of cardiovascular medicine, University of Fukui Hospital
  • Ikeda Estuko
    Department of cardiovascular medicine, University of Fukui Hospital
  • Fuji Ako
    Department of cardiovascular medicine, University of Fukui Hospital
  • Miyoshi Machiko
    Department of cardiovascular medicine, University of Fukui Hospital
  • Hisazaki Kaori
    Department of cardiovascular medicine, University of Fukui Hospital
  • Yamaguchi Jyunya
    Department of cardiovascular medicine, University of Fukui Hospital
  • Jong-dae Lee
    Department of cardiovascular medicine, University of Fukui Hospital
  • Tada Hiroshi
    Department of cardiovascular medicine, University of Fukui Hospital

Bibliographic Information

Other Title
  • 劇症型心筋炎に重篤な冠攣縮を合併した1例

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Description

症例は61歳, 男性. 先行する感冒症状があり, 心電図上広範囲のST上昇と心臓超音波検査にて著明な心機能低下・心筋の浮腫を認めたため劇症型心筋炎と診断した. IABP挿入下にICU管理としたが, 第2病日に心室頻拍となり血行動態の破綻をきたしたため, 人工呼吸器管理ならびにPCPS・CHDFを追加し, 血行動態の保持を行った. 壁運動は経時的に改善し, 第12病日にIABP, PCPSから離脱することが可能となった. しかし, 第22病日に突然の徐脈, 心停止をきたした. 心停止直前の心電図ではSTの上昇がみられ, また入院時の冠動脈造影にて有意狭窄なかったこと, 冠拡張薬の投与にて徐脈ならびにST上昇がすみやかに改善したため, 冠攣縮性狭心症による心停止と判断した. その後は危険な不整脈や心不全の再増悪なく経過し, 血液濾過透析が必要なものの社会復帰が可能となった. 劇症型心筋炎に重篤な冠攣縮を合併した稀有な一例を経験したため報告する.

Journal

  • Shinzo

    Shinzo 46 (SUPPL.2), S2_121-S2_125, 2014

    Japan Heart Foundation

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