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首页> 外文期刊>BMC Psychiatry >Excited catatonia in a patient with fatal pulmonary embolism and a successful treatment strategy
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Excited catatonia in a patient with fatal pulmonary embolism and a successful treatment strategy

机译：致命性肺栓塞患者的兴奋性卡塔顿病和成功的治疗策略

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Patients with psychiatric disorders in critical condition are difficult to treat. In this study, we report on a patient with underlying schizoaffective disorder who developed catatonia, cardiac arrest, and pulmonary embolism, as well as a successful treatment strategy. The inpatient is a 41-year-old morbidly obese male with schizoaffective disorder whose clozapine dosage was titrated from 100?mg to 175?mg due to auditory hallucination and agitation. The patient abruptly developed acute cardiopulmonary symptoms associated with an elevated troponin-I level. He was transferred to a cardiac intensive care unit, where he remained for 3?days. He was also found to have excited catatonic symptoms, and the lorazepam-diazepam protocol was initiated to quickly relieve the catatonia. Once the coronary angiogram was read as normal, the patient was transferred back to the psychiatric ward. However, the patient then suffered from in-hospital cardiac arrest. He was resuscitated and again transferred to the medical intensive care unit. Computed tomography confirmed the diagnosis of a pulmonary embolism. The patient was treated with Rivaroxaban 30?mg/d for the first 21?days, followed by 20?mg daily for 3?months. To control his severe and refractory psychotic symptoms, the patient was re-prescribed clozapine. During the 15-month follow-up period, the patient demonstrated a fair response and tolerability to clozapine 150?mg without symptoms relapse and no thromboembolic event. This report can serve to remind psychiatrists and physicians to be aware of fatal conditions in patients with psychiatric diseases and physical illnesses.
机译：处于危急状态的精神疾病患者难以治疗。在这项研究中，我们报道了一名患有精神分裂症的潜在患者，该患者发生了卡塔尼亚症，心脏骤停和肺栓塞，以及成功的治疗策略。住院患者是一名患有分裂情感障碍的41岁病态肥胖男性，由于听觉幻觉和躁动，氯氮平的剂量从100mg增加到175mg。该患者突然出现与肌钙蛋白I水平升高相关的急性心肺症状。他被转到心脏重症监护室，在那里待了3天。还发现他有激动的紧张症状，劳拉西m-地西p方案已开始实施，以迅速缓解该紧张症。一旦冠状动脉血管造影被正常读取，就将患者转移回精神病房。然而，患者随后遭受院内心脏骤停。他得到了复苏，并再次转到医疗重症监护室。计算机体层摄影术证实了肺栓塞的诊断。在最初的21天中，该患者接受了30毫克/天的利伐沙班治疗，随后3个月中每天20毫克的剂量。为了控制他的严重和难治性精神病症状，患者重新开了氯氮平处方。在15个月的随访期间，该患者对氯氮平150 mg表现出良好的反应和耐受性，且无症状复发和血栓栓塞事件。该报告可以提醒精神科医生和医师注意精神疾病和身体疾病患者的致命状况。

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