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Acute pulmonary edema due to stress cardiomyopathy in a patient with aortic stenosis: a case report

机译:主动脉瓣狭窄患者因应激性心肌病引起的急性肺水肿:一例报告

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Introduction Stress cardiomyopathy is a condition of chest pain, breathlessness, abnormal heart rhythms and sometimes congestive heart failure or shock precipitated by intense mental or physical stress. Case presentation A 64-year-old male with a known diagnosis of moderate-to-severe aortic stenosis and advised that valve replacement was not urgent, presented with acute pulmonary edema following extraordinary mental distress. The patient was misdiagnosed as having a "massive heart attack" and died when managed by a traditional protocol for acute myocardial infarction/coronary artery disease, irrespective of his known aortic stenosis. Conclusion Intense mental stress poses a considerable risk, particularly to patients with significant aortic stenosis. As described here, it can precipitate acute pulmonary edema. Importantly, effective management of acute pulmonary edema due to stress cardiomyopathy in patients with known aortic stenosis requires its distinction from acute pulmonary edema caused by an acute myocardial infarction. Treatment options include primarily urgent rhythm and/or rate control, as well as cautious vasodilation.
机译:引言应激性心肌病是一种胸痛,呼吸困难,心律异常,有时充血性心力衰竭或强烈的精神或身体压力引起的休克的疾病。病例介绍一名64岁的男性,已知诊断为中度至重度主动脉瓣狭窄,并建议不要紧急更换瓣膜,在极度精神困扰后会出现急性肺水肿。该患者被误诊为“大规模心脏病发作”,并在接受急性心肌梗塞/冠状动脉疾病的传统治疗方案治疗后死亡,无论其已知的主动脉瓣狭窄如何。结论强烈的精神压力会带来相当大的风险,特别是对于患有严重主动脉瓣狭窄的患者。如此处所述,它可导致急性肺水肿。重要的是,对已知主动脉瓣狭窄患者因应激性心肌病而导致的急性肺水肿的有效管理需要与急性心肌梗死引起的急性肺水肿区分开来。治疗选择主要包括紧急心律和/或心律控制,以及谨慎的血管舒张。

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