書誌事項
- タイトル別名
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- A case of ventricular fibrillation occurring in a patient with undiagnosed dilated cardiomyopathy during general anesthesia
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Preoperative medical examinations in a 58-year-old male scheduled for maxillofacial reconstructive surgery revealed no findings of cardiac dysfunctions and morbidity, including ECG and echocardiography by an experienced cardiologist.<BR>Anesthesia was uneventfully induced with fentanyl, midazolam and vecuronium for tracheal intubation and maintained with N2O-O2-low-flow isoflurane supplemented with fentanyl. Just during cervical angiorrhaphy the short runs of VT abruptly occurred. Immediate bolus injection of lidocaine successfully restored sinus rhythm. Approximately two hours later VT paroxysmally recurred, followed by Vf. Repeated electric defibrillation combined with essential emergency medication was promptly administered without any effects. This persistent dysrhythmias unresponsive to reanimation therapy, which were then judged signs suggestive of der ivation from some myocardial impairment, resulted in cardiac standstill. Autopsy revealed the result that the immediate cause of mortality was estimated as acute cardiac failure due to dilatation of both ventricles, especially marked of right ventricle. Therefore, latent myocardial disorder such as dilated cardiomyopathy was markedly considered to be accompanied by lethal arrhythmogenesis.<BR>This case emphasized that it should be an urgent important question for anesthesiologists as well as cardiologists to establish reliable clinical means of assessing and identifying potential cardiac pathology in asymptomatic carriers with much more accuracy.
収録刊行物
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- 蘇生
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蘇生 23 (1), 18-21, 2004
日本蘇生学会
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詳細情報 詳細情報について
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- CRID
- 1390282681434009472
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- NII論文ID
- 10012117763
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- NII書誌ID
- AN10043787
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- ISSN
- 1884748X
- 02884348
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可