| 作成者 |
|
|
|
|
|
|
|
| 本文言語 |
|
| 出版者 |
|
|
|
| 発行日 |
|
| 収録物名 |
|
| 巻 |
|
| 号 |
|
| 開始ページ |
|
| 終了ページ |
|
| 出版タイプ |
|
| アクセス権 |
|
| JaLC DOI |
|
| 関連DOI |
|
| 関連URI |
|
| 関連HDL |
|
| 概要 |
We present 2 cases of sudden death in obese psychiatric patients who had microscopic cardiopulmonary abnormalities. Postmortem analysis of the bloods from both patients detected several kinds of psych...iatric drugs, however their levels were below the lethal level. Case 1 was a 33-year-old woman and her heart showed severe fatty infiltration in the atrioventricular (AV) node and left- sided His which was compressed by hypertrophic septal myocardium and hypertensive pulmonary arteriopathy with endocardial thickening of the right atrium and ventricle. Case 2 was a 37-year-old woman and her heart showed mild downward displacement of the tricuspid valve with severe stenosis of the AV node artery. The cause of death in Case 1 was considered to be acute poisoning by three psychiatric drugs through their effect on the preceding cardiopulmonary abnormalities, while that in Case 2 was considered to be the fatal arrhythmia due to occlusion of the AV node artery resulting from the effect of three psychiatric drugs. These 2 cases suggest that microscopic cardiopulmonary abnormalities may be significant findings in obese psychiatric patients and may help in investigations into the manner of death. Further investigation may be needed for exploring the pathological mechanisms of these abnormal findings in obese and/or psychiatric patient.
病理組織学的に心刺激伝導系や肺に異常所見を認めた肥満を伴う精神病患者の突然死の2例を報告する. 共に剖検後の中毒学的検査では, その薬物血中濃度は致死濃度に達していなかった. 症例1は33才の女性で, 聴取した病歴からは睡眠時無呼吸であった可能性がある. 右心系の心内膜肥厚, 房室結節への高度の脂肪浸潤, His束の左方変位と右側中隔心筋からの高度圧排が認められ, 肺に は, 肺高血圧症の存在を示唆する多数の小動脈の狭窄像が認められた. 症例2は37才の女性で, 三尖弁中隔尖の軽度の落ち込み, 房室結節動脈の高度狭窄を認めた. この2例は後天的に形成された刺激伝導系を主体とする心臓の異常, 肺小動脈の異常が突然死の発症に関与したことが伺われ, 従来詳細に検索されてこなかった肥満を伴う精神科患者の突然死の一つの原因になっていることが推 察された.続きを見る
|
Mendeley出力
fam94_4_p066