書誌事項
- タイトル別名
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- A case of acute myocardial infarction induced by coronary microvascular spasm after acute carbon monoxide poisoning
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We report herein a case of carbon monoxide-induced coronary microvascular spasm diagnosed by coronary angiography (CAG) performed during acute ST elevation. The patient was a 45-year-old man admitted to our hospital due to carbon monoxide poisoning following attempted suicide. Despite initial satisfactory progress, on the sixth hospital day he developed sudden ventricular tachycardia and marked ST elevation was revealed by electrocardiography. We performed CAG immediately, but the ST elevation disappeared nearly simultaneously. No significant stenosis was observed and provocation testing for coronary artery spasm was also negative. Ventricular tachycardia recurred on the seventh hospital day and CAG was repeated during ST elevation. Although no stenosis or thrombotic lesions was found in the coronary arteries, marked delayed enhancement was observed in the right coronary artery, leading to a diagnosis of coronary microvascular spasm. Creatine phosphokinase levels increased to 2660 IU/l and myocardial infarction developed. There have been occasional reports of myocardial infarction due to carbon monoxide poisoning caused by coronary vasospasm involvement in addition to tissue hypoxia and mitochondrial dysfunction. However, to our knowledge, the present case represents the first diagnosis of this condition based on observation of coronary microvascular spasm on CAG performed during the acute phase of ST elevation.
収録刊行物
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- 日本救急医学会雑誌
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日本救急医学会雑誌 23 (11), 787-792, 2012
一般社団法人 日本救急医学会
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詳細情報 詳細情報について
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- CRID
- 1390282679347716864
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- NII論文ID
- 130004840899
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- ISSN
- 18833772
- 0915924X
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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
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- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可