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급성 전격성 심근염 회복 후 지속된 완전 방실 차단

Persistent Complete Atrioventricular Block after Recovery from Acute Fulminant Myocarditis

  • 박보민 (인제대학교 의과대학 해운대백병원 내과학교실) ;
  • 설상훈 (인제대학교 의과대학 해운대백병원 내과학교실) ;
  • 박승현 (인제대학교 의과대학 해운대백병원 내과학교실) ;
  • 이주원 (인제대학교 의과대학 해운대백병원 내과학교실) ;
  • 김동기 (인제대학교 의과대학 해운대백병원 내과학교실) ;
  • 김기훈 (인제대학교 의과대학 해운대백병원 내과학교실) ;
  • 김두일 (인제대학교 의과대학 해운대백병원 내과학교실)
  • Park, Bo Min (Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University) ;
  • Seol, Sang-Hoon (Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University) ;
  • Park, Seung-Hyun (Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University) ;
  • Lee, Joo-Won (Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Dong-Kie (Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Ki-Hun (Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Doo-Il (Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University)
  • 발행 : 2012.11.01

초록

상복부 복통을 호소한 환자가 심전도에서 ST분절 상승과 좌심실 기능저하를 보이면서 발생한 심정지로, 심폐소생술 및 체외막 산화, 임시형 심박동기를 시행하여 급성 심인성 쇼크 상태에서 지지적 치료를 시행하였고, 이후 좌심실의 기능 회복과 전신적 상태 호전으로 긍정적 치료 경과를 보였으나 완전 방실 차단이 지속되어 영구형 심박동기를 삽입해 야 했던 급성 심근염 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Acute myocarditis can be caused by viral, bacterial, or protozoal infection, or drug toxicity. Fulminant myocarditis progresses rapidly and frequently leads to cardiogenic shock, so patients should be supported by extracorporeal membrane oxygenation (ECMO), an intra-aortic balloon pump (IABP), mechanical ventilation, or a temporary pacemaker to maintain hemodynamic status. Most patients recover with supportive therapy. However, a few patients have persistent atrioventricular (AV) block. We report the case of a 34-year-old male with persistent complete atrioventricular block after the regression of acute myocarditis. Ultimately, a permanent pacemaker was implanted.

키워드

참고문헌

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