ĐẶC ĐIỂM TỔN THƯƠNG TIM Ở BỆNH NHÂN PHẢN VỆ

Abstract

Research objective: Describe characteristics of cardiac injury in anaphylactic patients. Research subjects and methods: 99 patients diagnosed with anaphylaxis of grade II or higher according to the standards specified in Circular No. 51/2017/TT-BYT on guidelines for prevention, diagnosis and treatment of anaphylaxis from January January 2021 to October 2022 at the Intensive Care Center - Bach Mai Hospital, including 38 patients with heart injury (diagnosed when having 1 of 3 characteristics: Arrhythmia, heart failure heart according to the standards of the European Society of Cardiology ESC 2019¹, elevated cardiac troponin with at least one value above the reference limit on the 99th percentile (according to the European Society of Cardiology ESC 2019¹), collected indicators Heart rate, blood pressure, electrocardiogram, echocardiography, Troponin concentration MS: on the day of admission. Calculate the percentage of qualitative variables, quantitative variables expressed by mean values, degree standard deviation, median, minimum value, maximum value, compare mean values by t-test, compare percentages by χ2 (Fisher exact test). Research results: 99 patients had anaphylaxis of grade II or higher, including 38 (38.38%) patients with heart injury. In the heart injury group, there were diverse manifestations of cardiovascular symptoms: circulatory arrest (26.3%), cardiogenic shock (52.6%), dangerous arrhythmias (23.7%), acute pulmonary edema (28.3%), accompanied by rapid pulse, low mean blood pressure, Troponin Ths concentration 1344 ± 171.1, NTproBNP 663 ± 524, reduced left ventricular total blood fraction (EF) found in 93.7% of patients with lesions. Heart injury and reduced wall motion were found in 84.2%. Conclusion: Heart injury in anaphylactic patients develops unpredictably, it is necessary to pay attention to monitoring, checking, and evaluating injury in all patients with anaphylaxis from level II or higher.