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증례 : 순환기 ; 임시형 심박조율기 삽입 후 발생한 조율 허용성 다형 심실빈맥 1예
박재영 ( Jae Young Park ),곽성동 ( Seong Dong Kwak ),임주견 ( Ju Kyeon Yim ),정재식 ( Jae Shik Jeong ),천재홍 ( Jae Hong Chun ),최성열 ( Sung Yeol Choi ),정준훈 ( Joon Hoon Jeong ) 대한내과학회 2009 대한내과학회지 Vol.77 No.5S
저자들은 하벽의 급성 심근경색증 환자에서 VVI 방식의 임시형 심박조율기를 삽입한 후 심박조율기 오작동으로 인한 조율 허용성 다형 심실빈맥을 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다. A 74-year-old man was admitted with sudden-onset chest pain. Electrocardiography showed ST segment elevation in leads II, III, and aVF; in addition, the levels of several cardiac enzymes were elevated. The patient received a VVI temporary pacemaker due to bradycardia (45 beats/min) and was subjected to primary percutaneous coronary intervention. After percutaneous coronary intervention for the RCA infarction, the patient was admitted to the coronary care unit. Six hours later, polymorphic ventricular tachycardia occurred following a short-long-short sequence. This is the first case of temporary pacemaker-permitted ventricular tachycardia in Korea. Here we present a case of pacemaker-permitted polymorphic ventricular tachycardia in a patient with inferior acute myocardial infarction. (Korean J Med 77:S1157-S1161, 2009)
증례 : 순환기 ; 국한된 ST 분절 상승을 보인 심근경색으로 오인된 급성 심근심막염 1예
김태욱 ( Tae Wook Kim ),정민정 ( Min Jeong Jeong ),임준영 ( Jun Young Im ),정재식 ( Jae Shik Jeong ),박미란 ( Mi Ran Park ),박주철 ( Ju Cheol Park ),정준호 ( Joon Hoon Jeong ) 대한내과학회 2011 대한내과학회지 Vol.80 No.1
본 증례의 환자는 급성 상기도 감염의 증상 이후 발생한 흉부 불편감을 주소로 내원하였고, 국한된 ST 분절의 상승과 심근 효소의 상승으로 급성 심근경색증이 의심되었으나, 심장 초음파 및 관상동맥 조영술을 시행한 이후 급성 심근심막염으로 진단할 수 있었고, 이를 대증적 치료로 완치하였다. 이에 본 저자들은 급성 심근경색증의 소견을 보인 급성 심근심막염 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Although, with regard to diagnosis, history, physical examination, laboratory data, and electrocardiogram (ECG) are helpful, it can be difficult to distinguish between pericarditis, myopericarditis, and myocardial infarction. Typically, the ECG pattern evolves similarly in acute pericarditis and myopericarditis and includes diffuse ST elevation and PR depression, and then diffuse T wave inversion. Nevertheless, atypical ECG features are seen occasionally in both, especially in myopericarditis. They are characterized by localized ST elevation (inferolateral or anterolateral) and T wave inversion before ST segment normalization. This makes it difficult to distinguish acute myopericarditis from acute myocardial infarction. We report the case of a 27-year-old man with acute myopericarditis with localized ST elevation mimicking acute myocardial infarction. (Korean J Med 2011;80:92-96)
김태욱 ( Tae Wook Kim ),박미란 ( Mi Ran Park ),이충원 ( Choong Won Lee ),정민정 ( Min Jeong Jeong ),임준영 ( Jun Young Im ),정재식 ( Jae Shik Jeong ) 대한류마티스학회 2010 대한류마티스학회지 Vol.17 No.4
Human immunodeficiency virus infection is associated with a variety of rheumatic manifestations. The pathogenic mechanisms are not well defined, but evidences suggests multiple mechanisms, including direct or indirect human immunodeficiency virus involvement with a genetic, immunological, and environmental basis. Rheumatic manifestations can occur during the course of human immunodeficiency virus infection, and their presence is associated with an overall poor prognosis for the underlying human immunodeficiency virus infection. We report a case of a 37-year-old male who had ankylosing spondylitis with a human immunodeficiency virus infection.