高度低血圧に対し昇圧目的で使用したノルアドレナリンの投与を契機として発症したたこつぼ型心筋症の1症例

A Case of Takotsubo Cardiomyopathy Triggered by Norepinephrine Administered to Raise the Blood Pressure of a Patient with Severe Hypotension

要旨

　重篤な低血圧に対し，昇圧目的で使用したノルアドレナリンの投与を契機として発症したたこつぼ型心筋症を経験した。アドレナリンと比べるとノルアドレナリンによるたこつぼ型心筋症はまれであるが，ノルアドレナリンでも本心筋症が起こりうることを念頭に置き，急性冠症候群類似の心電図変化を認めた際は本症の鑑別を考慮すべきである。

　A man in his 80s underwent laminectomy of the atlas. When noradrenaline was administered for severe hypotension after the induction of anesthesia, his blood pressure was elevated but electrocardiography showed ST elevation. Acute coronary syndrome was suspected, but emergency coronary angiography revealed no significant coronary artery stenosis. The echocardiography findings led to a diagnosis of Takotsubo cardiomyopathy. Takotsubo cardiomyopathy caused by noradrenaline is rare compared to cases caused by adrenaline, but when noradrenaline is administered, clinicians should keep in mind that Takotsubo cardiomyopathy can occur. In addition, if electrocardiographic changes such as acute coronary syndrome are observed, the differential diagnosis of Takotsubo cardiomyopathy should be considered.