http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
당뇨병 만성 콩팥병 환자에서 요로감염 패혈증과 연관된 무통성 급성 심근경색
김기준,장경윤,박훈석,진동찬,김형욱 조선대학교 의학연구소 2014 The Medical Journal of Chosun University Vol.39 No.3
A 72-year-old woman with diabetic chronic kidney disease visited the authors’ hospital with fever, dysuria, and left flank pain. She did not complain of typical angina upon her admission, however, given the presence of a new-onset left-bundle branch block, elevated cardiac enzymes, and documented E. coli septicemia, coronary angiography and percutaneous coro-nary interventions were performed for the mid-left anterior descending artery and the mid-to distal-right coronary artery. We should keep in mind that urosepsis in patients with diabetic chronic kidney disease, who are at high risk of cardiovascular disease, can be associated with painless acute myocardial Infarction.
( Eun Woo Choi ),( Ji Yoon Jung ),( Jun Huck Su ),( Sae Huyn Park ),( Kyu Hyang Cho ),( Kyung Woo Yoon ),( Jong Won Park ),( Jun Young Do ),( Seok Hui Kang ) 영남대학교 의과대학 2015 Yeungnam University Journal of Medicine Vol.32 No.2
Arrhythmias are complications of tunneled cuffed hemodialysis catheter insertion. Most complications associated with arrhythmias occur during guide-wire access, where the guide wire can cause traumatic damage to the conduction system of the heart. Conducting system injury in tunneled cuffed hemodialysis catheter insertion often involves the right bundle, causing right bundle branch block (RBBB). Transient RBBB with sinus rhythm is not usually accompanied by abnormal vital signs. However if patients already have left bundle branch block (LBBB), new onset RBBB can cause complete atrioventricular block (AVB), which can lead to fatal complications requiring invasive treatment. We report on a patient with LBBB who developed complete AVB during hemodialysis catheter insertion.
Choi, Eun Woo,Jung, Ji Yoon,Su, Jun Huck,Park, Sae Huyn,Cho, Kyu Hyang,Yoon, Kyung Woo,Park, Jong Won,Do, Jun Young,Kang, Seok Hui Yeungnam University College of Medicine 2015 Yeungnam University Journal of Medicine Vol.32 No.2
Arrhythmias are complications of tunneled cuffed hemodialysis catheter insertion. Most complications associated with arrhythmias occur during guide-wire access, where the guide wire can cause traumatic damage to the conduction system of the heart. Conducting system injury in tunneled cuffed hemodialysis catheter insertion often involves the right bundle, causing right bundle branch block (RBBB). Transient RBBB with sinus rhythm is not usually accompanied by abnormal vital signs. However if patients already have left bundle branch block (LBBB), new onset RBBB can cause complete atrioventricular block (AVB), which can lead to fatal complications requiring invasive treatment. We report on a patient with LBBB who developed complete AVB during hemodialysis catheter insertion.
최은우,정지윤,서준혁,박세현,조규향,윤경우,박종원,도준영,강석휘 영남대학교 의과대학 2015 Yeungnam University Journal of Medicine Vol.32 No.2
Arrhythmias are complications of tunneled cuffed hemodialysis catheter insertion. Most complications associated with arrhythmias occur during guide-wire access, where the guide wire can cause traumatic damage to the conduction system of the heart. Conducting system injury in tunneled cuffed hemodialysis catheter insertion often involves the right bundle, causing right bundle branch block (RBBB). Transient RBBB with sinus rhythm is not usually accompanied by abnormal vital signs. However if patients already have left bundle branch block (LBBB), new onset RBBB can cause complete atrioventricular block (AVB), which can lead to fatal complications requiring invasive treatment. We report on a patient with LBBB who developed complete AVB during hemodialysis catheter insertion.
이송이 ( Song Yi Lee ),김미경 ( Mi Kyeong Kim ),신옥영 ( Ok Young Shin ) 경희대학교 경희의료원 2011 慶熙醫學 Vol.27 No.1
A patient with uncertain history of angina went under general anesthesia for nasal septoplasty. During the perioperative period, his previously normal ECG developed a left bundle branch block (LBBB). LBBBs occuring during anesthesia is a rare event, but can be an important sign for acute myocardial infarction or myocardial ischemia. In this patient, with the injection of esmolol, his heart rate decreased and the ECG changed back to normal sinus rhythm. This kind of heart rate dependent LBBB is a benign disease not directly related to myocardial ischemia, but adequate preoperative cardiac evaluation is still needed to differentiate from myocardial ischemia. differentiate from myocardial ischemia.
좌각차단 환자에서 급성심근경색 진단을 위한 새로운 알고리듬
김동민,오성범 대한응급의학회 2018 대한응급의학회지 Vol.29 No.1
Purpose: Patients with a suspected acute myocardial infarction (AMI) in the setting of a new or presumably new left bundle branch block (LBBB) present an important diagnostic and therapeutic challenge to clinicians. This study was conducted to identify the frequency of ST-segment elevation myocardial infarction (STEMI)-equivalent in this population, determine the diagnostic value of electrocardiographic and echocardiographic features and propose a new diagnostic algorithm. Methods: From 793 patients who underwent emergent coronary angiography between January 1, 2012 and July 31, 2015, we examined data pertaining to 21 patients with new or presumably new LBBB. These patients were classified into three groups: 1) STEMI-equivalent, defined as an acute coronary occlusion on coronary angiogram (six patients), 2) non- STEMI (NSTEMI) (six patients), and 3) diagnosis other than myocardial infarction (non-MI) (nine patients). Results: Six patients who met the ST-segment concordance criteria (score≥3) were STEMI-equivalent. On the other hand, seven patients with a discordant ST-elevation of ≥5 mm (score=2) were NSTEMI or non-MI. Therefore ST-segment concordance was highly sensitive and specific for the diagnosis of STEMI-equivalent. Compared with NSTEMI patients, nine non-MI patients with a normal angiogram had a low ejection fraction (35.6±19.0 vs. 56.0±12.9, p=0.04) and increased left ventricle end-diastolic dimension (63.9±8.8 vs. 51.7±6.4, p=0.012). Conclusion: Only a minority of patients with LBBB and suspected AMI have a STEMI-equivalent. Low ejection fraction and increased end-diastolic dimension of left ventricle indicate normal coronary angiogram in patients without ST-segment concordance of Sgarbossa criteria. We propose a new modified diagnostic algorithm in this population.
감시 하 진정 마취 중 저산소증과 함께 나타난 좌각차단-증례 보고-
손희원,박은선,허인영,김강일,이아란,김안숙,박순은,김성훈 대한마취통증의학회 2014 Anesthesia and pain medicine Vol.9 No.2
Transient left bundle branch block (LBBB) is uncommon duringanesthesia. It is mainly related to the changes in blood pressureor heart rate. Its occurrence can be confused with acute myocardialischemia or ventricular tachycardia, therefore differential diagnosisis important. We report a case of transient LBBB which developedwith hypoxia during monitored anesthesia care. LBBB is reversedto sinus rhythm after recovery from hypoxia.
전신마취하에 양극성 고관절 반치환술을 받는 환자에서 간헐적 좌각차단의 해소
조용현 ( Yong Hyun Cho ),신광일 ( Kwang Il Shin ),신옥영 ( Ok Young Shin ),김선희 ( Sun Hee Kim ),장원 ( Won Jang ),( Hyun Seok Lee ),고현철 ( Hyun Chul Go ),고우형 ( Woo Hyeong Ko ),권재현 ( Jae Hyun Kwon ),김영도 ( Young Do 경희대학교 경희의료원 2022 慶熙醫學 Vol.37 No.1
Intermittent left bundle branch block (LBBB) can be caused by cardiovascular disease, and in this case, it can be a factor that increases the patient's mortality, so the patient should be treated with caution. We experienced a case of bipolar hemiarthroplasty of an 87-year-old female with angina history under general anesthesia. Preoperative electrocardiography showed complete LBBB without subjective symptoms. We report a case of intermittent LBBB which changed to a normal sinus rhythm after injecting phenylephrine.