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首页> 外文期刊>Case Reports in Cardiology >Acute Pericarditis Occurring Three Days after Intravesical Instillation of Mitomycin C after Transurethral Bladder Tumor Resection in a 64-Year-Old Woman
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Acute Pericarditis Occurring Three Days after Intravesical Instillation of Mitomycin C after Transurethral Bladder Tumor Resection in a 64-Year-Old Woman

机译：一名64岁妇女经尿道膀胱肿瘤切除术后丝裂霉素C膀胱内滴注三天后发生急性心包炎

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We present a 64-year-old woman who developed symptoms of acute pericarditis three days after undergoing intravesical instillation of mitomycin C following transurethral bladder tumor resection. Mitomycin C is a chemotherapeutic agent which acts by alkylation of DNA and is known to be cardiotoxic when systemically administered. Despite classic pericarditis symptoms, the patient underwent an urgent coronary angiogram due to elevated cardiac troponin I level, EKG changes, and wall motion abnormalities on her echocardiogram. During her angiogram, it was found that she had multiple stenotic coronary artery lesions, with no acute total coronary occlusions, and percutaneous coronary intervention (PCI) was done with placement of a single drug-eluting stent for a 95% stenotic lesion in the left anterior descending artery. The patient was discharged after an uneventful hospitalization on dual antiplatelet therapy with aspirin and prasugrel, and colchicine for pericarditis. It is likely that the patient’s presentation was the result of a perimyocardial inflammatory process secondary to intravesically administered mitomycin C, rather than an acute coronary syndrome. While the pathophysiological basis of cardiotoxicity of systemically administered mitomycin C is well documented, more studies are needed to determine whether intravesical MMC may cause cardiotoxicity.
机译：我们介绍了一位64岁的女性，在经尿道膀胱肿瘤切除术后行膀胱内灌注丝裂霉素C后三天出现了急性心包炎的症状。丝裂霉素C是一种化学治疗剂，可通过DNA烷基化作用发挥作用，已知全身给药时具有心脏毒性。尽管有典型的心包炎症状，但由于心脏肌钙蛋白I水平升高，EKG变化和超声心动图壁运动异常，患者仍接受了紧急冠状动脉造影检查。在进行血管造影时，发现她有多个狭窄的冠状动脉病变，没有急性总的冠状动脉阻塞，并且经皮冠状动脉介入治疗（PCI）是通过在左侧放置单个药物洗脱支架进行的，以治疗95％的狭窄病变前降动脉。患者在接受阿司匹林和普拉格雷，秋水仙碱治疗心包炎的双重抗血小板治疗后住院顺利，出院。患者的表现很可能是由于膀胱内施用丝裂霉素C继发的心包炎性过程，而不是急性冠状动脉综合征。尽管全身性施用丝裂霉素C的心脏毒性的病理生理学基础已得到充分证明，但需要进行更多的研究以确定膀胱内MMC是否会引起心脏毒性。

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