即时超声识别失代偿性心力衰竭的年轻男性与甲基苯丙胺相关的心肌病呈现在严重败血症急诊科。

Case Reports in Emergency Medicine Pub Date : 2018-10-09 eCollection Date: 2018-01-01 DOI:10.1155/2018/2859676
David Kinas, Michael Dalley, Kayla Guidry, Mark A Newberry, David A Farcy
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引用次数: 3

摘要

我们描述了一个年轻的男性谁提出了严重的败血症和失代偿性心力衰竭与潜在的甲基苯丙胺相关的心肌病,以前未诊断急诊科。这种表现是独特的,因为甲基苯丙胺相关心肌病是一种罕见的报道条件,在严重败血症和失代偿性充血性心力衰竭的复杂临床情况下出现。我们讨论了在这个病例中我们如何使用即时超声(POCUS)来识别一个未被怀疑的疾病过程,以及它如何改变了我们最初的复苏策略和管理。急诊医生可以利用即时超声(POCUS)在急诊科帮助识别这些高危患者,并指导适当的复苏。甲基苯丙胺相关心肌病(MAC)是一种罕见的甲基苯丙胺滥用并发症,最常见的表现为非缺血性扩张型心肌病。随着美国甲基苯丙胺滥用的增加,甲基苯丙胺使用的并发症更常出现在急诊科。以戒除安非他明为目标的适当教育和康复,可能使患者有可能恢复正常的心脏功能。由于大多数患者晚期出现严重心功能障碍,早期发现对于危重患者至关重要,因为识别可能会显著影响ED的管理。
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Point-of-Care Ultrasound Identifies Decompensated Heart Failure in a Young Male with Methamphetamine-Associated Cardiomyopathy Presenting in Severe Sepsis to the Emergency Department.

We describe a case of a young male who presents to the emergency department with severe sepsis and decompensated heart failure with underlying Methamphetamine-Associated Cardiomyopathy that was previously undiagnosed. This presentation is unique because Methamphetamine-Associated Cardiomyopathy is an uncommonly reported condition that presented in a complex clinical scenario of severe sepsis and decompensated congestive heart failure. We discuss how we used point-of-care ultrasound (POCUS) in this case to identify an unsuspected disease process and how it changed our initial resuscitation strategy and management. Emergency physicians can utilize point-of-care ultrasound (POCUS) to help identify these high-risk patients in the emergency department and guide appropriate resuscitation. Methamphetamine-Associated Cardiomyopathy (MAC) is an infrequently described complication of methamphetamine abuse, most commonly presented as a nonischemic dilated cardiomyopathy. With the rise in methamphetamine abuse in the United States, complications from methamphetamine use are more commonly presenting to the emergency department. Proper education and rehabilitation, with a goal of abstinence from amphetamine use, may allow patients to potentially regain normal cardiac function. Since the majority of patients present late with severe cardiac dysfunction, early detection is essential amongst critically ill patients since recognition may significantly influence ED management.

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