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2018, vol. 37, br. 2, str. 54-57
Oštećenje miokarda uzrokovano kombinacijom emocionalnog stresa i trovanja ugljen monoksidom - prikaz slučaja
Univerzitet u Novom Sadu, Medicinski fakultet, Institut za kardiovaskularne bolesti + Univerzitet u Novom Sadu, Medicinski fakultet
Ključne reči: trovanje ugljen monoksidom; kardiotoksičnost; takotsubo sindrom
Sažetak
Uvod: Ugljen monoksid (CO) je vodeći uzrok trovanja širom sveta. Centralni nervni sistem i srce imaju najveće potrebe za kiseonikom i mogu biti teško oštećeni u trovanju CO. Prikaz slučaja bolesnice starosti 39 godina koja je nakon snažnog emocionalnog stresa i trovanja CO upućena u Urgentni Centar. Pri inicijalnom pregledu ona je komatoznog stanja svesti, a u laboratorijskim vrednostima se regi-struju povišene vrednosti laktata (14.62), metHgb 0,3% i karboksihemoglobina 12,9%. U EKG-u registrovan sinusni ritam, srčane frekvencije 100/min, slab porast R talasa sa inverznim T talasima V1-V3 i bifaznim T talasima V5, V6. Transtorakalnom ehokardiografijom viđena je leva komora sa akinetičnim vrhom i svim apikalnim segmentima leve komore, snižene sistolne funkcije. Kardiospecifični enzimi su bili povišeni, urađena je koronarograija kojom se nađe uredan luminogram koronarnih krvnih sudova. Na osnovu svih parametara, postavljena je dijagnoza Takocubo sin-droma. Lečena je visokim dozama kiseonika na mehaničkoj ventilaciji, oralnim preparatima acetilsalicilne kiseline, inhibitorima angiotezin konvertujućeg enzima, beta blokatorima i statinima uz potpuni oporavak. Kontrolnom eho-kardiografijom, nakon mesec dana, opisuje se uredan nalaz. Zaključak: Trovanje CO do sada nije opisano kao precipitirajući faktor za razvoj Takotsubo sindroma. Dva riziko faktora trovanje ugljen monoksidom i stres inicirala su buru kateholamina koja je mogla da pokrene razvoj ovog specifičnog sindroma.
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O članku

jezik rada: engleski
vrsta rada: prikaz slučaja
DOI: 10.5937/siks1802054M
objavljen u SCIndeksu: 12.05.2019.