급성 전격성 심근염 회복 후 지속된 완전 방실 차단
Persistent Complete Atrioventricular Block after Recovery from Acute Fulminant Myocarditis
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초록
상복부 복통을 호소한 환자가 심전도에서 ST분절 상승과 좌심실 기능저하를 보이면서 발생한 심정지로, 심폐소생술 및 체외막 산화, 임시형 심박동기를 시행하여 급성 심인성 쇼크 상태에서 지지적 치료를 시행하였고, 이후 좌심실의 기능 회복과 전신적 상태 호전으로 긍정적 치료 경과를 보였으나 완전 방실 차단이 지속되어 영구형 심박동기를 삽입해야 했던 급성 심근염 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Acute myocarditis can be caused by viral, bacterial, or protozoal infection, or drug toxicity. Fulminant myocarditis progresses rapidly and frequently leads to cardiogenic shock, so patients should be supported by extracorporeal membrane oxygenation (ECMO), an intra-aortic balloon pump (IABP), mechanical ventilation, or a temporary pacemaker to maintain hemodynamic status. Most patients recover with supportive therapy. However, a few patients have persistent atrioventricular (AV) block. We report the case of a 34-year-old male with persistent complete atrioventricular block after the regression of acute myocarditis. Ultimately, a permanent pacemaker was implanted. (Korean J Med 2012;83:629-632)
참고문헌 (12)
- Feldman AM, "Myocarditis", N Engl J Med, 343, pp.1388~1398 (2000)
- Schultz JC, "Diagnosis and treatment of viral myocarditis", Mayo Clin Proc, 84, pp.1001~1009 (2009)
- Cooper LT Jr., "Myocarditis", N Engl J Med, 360, pp.1526~1538 (2009)
- Yasu T, "Acutely severe myocarditis successfully treated by percutaneous cardiopulmonary support applied by a newly developed heparinbinding oxygenator and circuits", Jpn Circ J, 61, pp.1037~1042 (1997)
- Acker MA., "Mechanical circulatory support for patients with acute-fulminant myocarditis", Ann Thorac Surg, 71(3 Suppl), pp.73~76 (2001)
- Chen YS, "Choice of mechanical support for fulminant myocarditis: ECMO vs. VAD?", Eur J Cardiothorac Surg, 27, pp.931~932 (2005)
- Arima M, "Recurrence of myocarditis presenting as pacing and sensing failure after implantation of a permanent pacemaker at first onset", Jpn Circ J, 65, pp.345~348 (2001)
- Batra AS, "The clinical course of acquired complete heart block in children with acute myocarditis", Pediatr Cardiol, 24, pp.495~497 (2003)
- Chien SJ, "Myocarditis complicated by complete atrioventricular block: nine years' experience in a medical center", Pediatr Neonatol, 49, pp.218~222 (2008)
- Terasaki F, "Ultrastructural alterations of the conduction system in mice exhibiting sinus arrest or heart block during Coxsackievirus B3 acute myocarditis", Am Heart J, 123, pp.439~452 (1992)
- Maury P, "Complete atrioventricular block persisting after regression of infectious myocarditis", J Electrocardiol, 41, pp.665~667 (2008)
- Hanawa H, "Recovery from complete atrioventricular block caused by idiopathic giant cell myocarditis after corticosteroid therapy", Jpn Circ J, 62, pp.211~214 (1998)