Japanese
English
- 有料閲覧
- Abstract 文献概要
- 1ページ目 Look Inside
要旨 患者は75歳女性.38℃台の発熱が続くため近医入院.心臓超音波検査で感染性心内膜炎が疑われたため,精査加療目的に2000年7月15日当院へ転院.転院時,炎症反応が亢進し,収縮期逆流性雑音が聴取された.血液培養にてMSSAが検出されたため,MEPMを投与開始したところ解熱.炎症反応は改善傾向にあった.8月27日18時30分頃突然胸痛を訴え,心電図変化より急性下壁梗塞が疑われた.ニトログリセリン静注にて胸痛が消失したため保存的治療を開始した.9月28日の心臓カテーテル検査で回旋枝に95%の狭窄を認め,4度の僧帽弁閉鎖不全症が確認されたため,11月27日に僧帽弁置換術が施行された.感染性心内膜炎に合併した急性心筋梗塞の報告は稀で,その発症機序と時期について文献的考察を加えて報告した.
Summary
A 75-year-old woman was admitted to Saitama Medical Center, because of fever and vegetation at the mitral valve. From our blood culture, MSSA was found and MEPM which was most sensitive to MSSA was started. After a few days, fever and other markers of infection gradually improved. However, 7 weeks after treatment, the patient suddenly complained of chest pain. ECG showed inferior myocardial infarction. After injection of nitroglycerin, her chest pain was relieved. September 28,cardiac catheterization was performed. Coronary arteriography showed 95% stenosis at the circumflex artery. Left ventriculography showed mitral valve reguritation grade 4. November 27, the patient was operated on and received mitral valve replacement. Infectious endocarditis with acute myocardial infarction is rare. We reported the mechanism and timing of thrombosis.
Copyright © 2005, Igaku-Shoin Ltd. All rights reserved.