摘要
淀粉样变心肌病是一种罕见的导致心律失常、心力衰竭的疾病,但恶性室性心律失常少见;由于淀粉样变心肌病早期无特异性临床表现,医师因对其临床认识不足,导致患者诊断延迟且预后差。本例患者以“不稳定型心绞痛”收住院,住院期间突发室颤2次,经抢救后患者恢复窦性心律,行冠状动脉造影术未见明显狭窄,暂不考虑室颤由于冠状动脉狭窄所致缺血引发,为防治恶性心律失常给予心律转复除颤器术;结合免疫球蛋白等检验及心电图、心脏超声、心脏核素等检查结果,初步考虑免疫球蛋白轻链AL型淀粉样变性心肌病。临床医师应及早对淀粉样变心肌病的高风险人群进行筛查,熟练掌握相关检查警示征等信息,在日常诊疗中做到早发现、早诊断、早治疗。本文将本例患者临床资料进行分析,汇总整理相关无创性检查等信息。
Starch like cardiomyopathy is a rare disease that causes arrhythmia and heart failure,but malignant ventricular arrhythmias are rare.Due to the lack of specific clinical manifestations in the early stages of amyloidosis cardiomyopathy,physicians have insufficient understanding of its clinical manifestations,resulting in delayed diagnosis and poor prognosis for patients.The patient in this case was admitted to the hospital with"unstable angina pectoris".During hospitalization,there were two sudden episodes of ventricular fibrillation.After rescue,the patient recovered sinus rhythm and underwent coronary angiography without obvious stenosis.Therefore,ventricular fibrillation is not considered to be caused by ischemia due to coronary artery stenosis.To prevent and treat malignant arrhythmias,defibrillation is performed.Based on the results of immunoglobulin and other tests,as well as electrocardiogram,cardiac ultrasound,cardiac nuclide,etc.,we preliminarily consider immunoglobulin light chain AL amyloidosis cardiomyopathy.Clinical physicians should screen high-risk populations for amyloidosis early,proficiently grasp relevant examination warning signs and other information,and achieve early detection,diagnosis,and treatment in daily diagnosis and treatment.This article analyzes the clinical data of the patient in this case,summarizes and organizes relevant non-invasive examination information.
作者
徐宝龙
王梅英
XU Baolong;WANG Meiying(Department of General Medicine,Minjiang Road Community Health Service Center,Hong Kong Middle Road Street,Shinan District,Qingdao,Shandong 266071,China;Department of Internal Medicine,Shinan District Integrated Traditional Chinese and Western Medicine Hospital,Qingdao,Shandong 266071,China)
出处
《中国医药指南》
2025年第20期137-140,共4页
Guide of China Medicine
关键词
心肌病
淀粉样变性
心室颤动
诊断
Cardiomyopathy
Amyloidosis
Ventricular fibrillation
Diagnosis
