Avtor/Urednik		Kirbiš, Simona; Sinkovič, Andreja
Naslov		Prikaz primera bolnika s kardiogenim šokom po infarktu srca - ukrepi in zdravljenje
Prevedeni naslov		Acute heart failure in a patient with acute myocardial infarction - case report
Tip		članek
Vir		In: Hojs R, editor. Zbornik prispevkov 20. srečanje internistov in zdravnikov družinske medicine "Iz prakse za prakso" ; 2009 maj 8-9; Maribor. Maribor: Univerzitetni klinični center,
Leto izdaje		2009
Obseg		str. 119-23
Jezik		slo
Abstrakt		We present two patients with acute heart failure that were treated in lntensive Care Unit (ICU) at University Clinical center Maribor. The first patient had inferior acute myocardial infarction with ST elevation. He had ventricular fibrillation and was successfully defibrillated. Before admission, cardiogenic shock with respiratory failure developed. The patient was intubated and mechanically ventilated and also inotropic support was needed. We immediately proceeded to primary percutaneous coronary intervention (PCI) and right coronary artery (RCA) was dilated and bare metal stent was placed in RCA. In the ICU we began with invasive hemodynamic monitoring with LiDCO method and because of low cardiac index he was treated with levosimendan. The second patient was admitted to hospital because of acute anterior myocardial infarction with ST elevation. At admission his blood pressure and pulse were within normal limits, he was in Kilip class l. Primary PCI and balloon dilatation of the left descending coronary artery (LAD) was complicated with LAD dissection. The patient became pale, wet, hypotensive and cardiogenic shock developed. Intraaortic balloon pump was inserted and patient needed urgent operation.
Izvleček		Za ponazoritev akutnega srčnega popuščanja smo izbrali dva bolnika, ki sta se zdravila na oddelku za internistično intenzivno terapijo Univerzitetnega kliničnega centra Maribor. Pri prvem bolniku je bil vzrok akutnega srčnega popuščanja akutni srčni infarkt spodnje stene z dvigom ST veznice. Že na terenu je bil zaradi prekatne fibrilacije oživljan. Zaradi akutnega srčnega popuščanja in ob tem respiratorne insuficience je bila potrebna intubacija in mehanična ventilacija ter vazopresorna podpora z noradrenalinom. Opravljena je bila primarna koronarna intervencija (PCI) in razrešena zapora na desni koronamiarteriji (DKA) z dilatacijo in vstavitvijo neprevlečene žilne opornice v DKA. Na oddelku smo se odločili za invazivni hemodinamski monitoring z metodo LiDCO ter zaradi nizkega srčnega indeksa uvedli inotropno podporo z levosimendanom. Po zdravljenjuje bil bolnik premeščen na oddelek. Drugi bolnik je bil pripeljan na internistično prvo pomoč zaradi akutnega srčnega infarkta sprednje stene z dvigom veznice ST. Ob sprejemu je bil neprizadet, normotenziven in normokarden ter kardiorespiratorno kompenziran, Killip l. Napravljena je bila PCI pri kateri je med dilatacijo leve sprednje descendentne koroname arterije prišlo do disekcije in ob tem se je razvil kardiogeni šok. Vstavljena je bila intraaortna balonska črpalka in bolnik je bil premeščen na oddelek za kirurgijo srca, kjer je bila opravljena urgentna operacija.
Deskriptorji		MYOCARDIAL INFARCTION HEMODYNAMICS SHOCK, CARDIOGENIC