评估心血管功能障碍使用心脏应变后Diphenhydramine过量服用后.
George G Kidess1, Nathan Roberts2, Lauren Harvey2
1Medicine, The University of Chicago Medicine, Chicago, USA.
Cureus
|February 11, 2026
概括
过量服用二胺可以引起微妙的心脏功能障碍,即使心电图正常. 全球纵向菌株 (GLS) 检测到这种左心室 (LV) 缩功能障碍,有助于急诊室 (ED) 诊断.
科学领域:
- 心脏病学 心脏病学
- 毒理学 毒理学 毒理学
- 紧急医疗 紧急医疗
背景情况:
- 多芬胺过量服用通常会导致抗肌糖毒性和心律失常.
- 左心室 (LV) 缩功能障碍是一种已知的并发症,通常与心电图 (ECG) 上的QRS延长有关.
- 在过量服用的情况下,细微的LV功能障碍可能会错过标准ECG评估.
研究的目的:
- 报告二胺过量用药的病例,呈现出抗肌糖毒性,但没有ECG指示的QRS延长.
- 在这种情况下,研究点照顾心声学和斑点跟踪在检测亚临床LV缩功能障碍方面的实用性.
- 突出全球纵向应变 (GLS) 在药物过量期间识别微妙心脏功能障碍方面的作用.
主要方法:
- 一个病人的病例报告,在过量服用迪芬胺后向急诊室 (ED) 报告.
- 临床评估抗糖毒性和心电图监测.
- 带有斑点跟踪的临床心声扫描,以评估 LV 缩功能,包括喷射分数 (EF) 和全球纵向应变 (GLS).
主要成果:
- 患者表现出抗肌肉毒性毒性症状,但心电图正常,没有QRS延长.
- 心声扫描显示了保留的喷射分数 (EF),但显著减少了全球纵向应变 (GLS).
- 这表明微妙的左心室 (LV) 缩功能障碍尽管正常的心电图发现.
结论:
- 全球纵向应变 (GLS) 是检测在二胺过量中亚临床 LV 系统功能障碍的敏感标志物,即使是正常的心电图.
- 照顾点回声心脏图和斑点跟踪可以在ED中成为有价值的工具,用于评估过量服用患者的心脏功能.
- 在药物滥用紧急情况中,GLS可能有助于早期识别和管理心脏毒性.
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