术中Kounis综合征与固定错误1例报告。

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A&A Practice Pub Date : 2023-03-01 DOI:10.1213/XAA.0000000000001672

Trent A Ogaz, BobbieJean Sweitzer

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引用次数: 1

摘要

诱导后低血压，虽然经常是由于麻醉药物，有多种原因。我们报告一例假定为术中Kounis综合征，或过敏引起的冠状血管痉挛，患者围手术期的过程最初归因于麻醉引起的低血压和医源性反弹高血压导致Takotsubo心肌病。患者在接受左乙拉西坦治疗后立即出现低血压复发的第二次麻醉事件似乎证实了Kounis综合征的诊断。在本报告中，我们讨论导致该患者最初误诊的固定错误。

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Intraoperative Kounis Syndrome and Fixation Errors: A Case Report.

Postinduction hypotension, though frequently due to anesthetic medications, has a variety of causes. We present a case of presumed intraoperative Kounis syndrome, or anaphylaxis-induced coronary vasospasm, in which the patient's perioperative course was initially attributed to anesthesia-induced hypotension and iatrogenic rebound hypertension leading to Takotsubo cardiomyopathy. A second anesthetic event with immediate recurrence of hypotension after the patient received levetiracetam appears to confirm the diagnosis of Kounis syndrome. In this report, we discuss the fixation error that led to this patient's original misdiagnosis.

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来源期刊

A&A Practice ANESTHESIOLOGY-

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期刊介绍： A & A Case Reports, our new online journal publishing Case Reports, related Editorial Commentary, and Correspondence. Anesthesia & Analgesia 1 and Anesthesiology 2 recently announced that they were suspending publication of Case Reports. One reason is that Case Reports typically reduce the Impact Factor of a journal because they are rarely cited. Regardless of the merits of Impact Factor as a metric of journal worth, journals and their editors necessarily consider Impact Factor in strategic planning. At the same time, Case Reports are appreciated by readers for describing “real life” management of difficult or unusual cases not often encountered by practitioners. In a recent issue of Anesthesia & Analgesia, Steven Shafer1 identified many Case Reports whose publication launched productive careers dedicated to solving the puzzle posed by an unusual observation in a single patient.