| Japanese |
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| Title | 手術終了後の体位変換時に気絶心筋(stunned myocardium)を来たした1症例 |
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| Subtitle | 症例 |
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| Authors | 植木隆介, 奥谷龍, 福島歩, 太城力良 |
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| Authors(kana) | |
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| Organization | 兵庫医科大学病院集中治療部 |
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| Journal | 循環制御 |
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| Volume | 23 |
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| Number | 1 |
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| Page | 45-48 |
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| Year/Month | 2002/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | はじめに 気絶心筋（stunned myocardium）は一過性の心筋虚血により心筋収縮力が低下し, 冠動脈が再灌流されたにもかかわらず心機能回復に数日ないし数週間を要する病態である. 今回, 著者らは腹臥位での手術終了後, 仰臥位に戻した直後にstunned myocardiumを生じ, その循環管理に難渋した症例を経験したので報告する. 症例 症例は56歳, 女性. 身長150cm, 体重43kg. 既往歴では慢性腎不全のため23年前より週3回の血液透析を受けていた. 高血圧症, 腎性貧血も合併していた. 透析性腰椎症の診断で, 第2-5腰椎後方除圧固定術が予定された. 術前検査では胸部X線画真上, 心胸比58％で肺うっ血像はなく, 異常を認めなかった. 安静時12誘導心電図では洞調律で, 軸変位もなく, 異常Q波, ST-T変化等の虚血性心疾患を疑わせる所見は認めなかった. 運動負荷心電図は腰椎症により下肢の運動能が低下していたため実施できなかった. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Stunned myocardium, Cardiogenic shock, Posture change, IABP |
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| English |
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| Title | Stunned Myocardium Concomitant with Postoperative Posture Change after Spinal Surgery |
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| Subtitle | |
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| Authors | Ryusuke Ueki, Ryu Okutani, Ayumi Fukushima, Chikara Tashiro |
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| Authors(kana) | |
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| Organization | Intensive Care Unit, Hyogo College of Medicine |
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| Journal | Circulation Control |
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| Volume | 23 |
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| Number | 1 |
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| Page | 45-48 |
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| Year/Month | 2002/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We experienced a patient with cardiogenic shock caused by stunned myocardium after postoperative posture change. The patient was a 56-year-old woman with chronic renal failure who had been treated by hemodialysis for the past 23 years. When her posture was changed from the prone position to the supine position after the end of spinal surgery, frequent ventricular premature beats and ST elevation were observed on ECG, and she was resulting in a state of , shock. Arterial pressure was increased by administeration of large doses of coronary vasodilator and catecholamines because we suspected either acute myocardial infarction or coronary spasm. ST elevation did not improve, and then, the patient was transferred to the ICU after initiation of IABP insertion. Since organic stenosis of coronary arteries was not detected on coronary angiography, the patient was seemed to be in diagnosed stunned myocardium. |
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| Practice | Basic medicine |
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| Keywords | Stunned myocardium, Cardiogenic shock, Posture change, IABP |
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