Two cases of sudden death in obese psychiatric patients with microscopic cardiopulmonary abnormalities.
Two cases of sudden death in obese psychiatric patients with microscopic cardiopulmonary abnormalities.
复制标题
两例患有显微心肺异常的肥胖精神病患者猝死。
DOI：
10.15017/18688
复制
发表时间：
2003
期刊：
影响因子：
--
通讯作者：
N. Ikeda
中科院分区：
文献类型：
--
作者：
N. Nishida;K. Kudo;Rie Esaki;N. Ikeda
我们报告2例因心肺镜检异常而猝死的肥胖精神病患者。对两名患者的血液进行了尸检分析，发现了几种精神药物，但它们的水平低于致命水平。例1为33岁女性，心脏表现为房室结和左侧His严重脂肪渗出，受室间隔心肌肥厚和高血压性肺动脉病压迫，右房和右室内膜增厚。例2为37岁女性，心脏表现为三尖瓣轻度下移，房室结动脉严重狭窄。例1的死亡原因是三种精神药物对先前心肺异常的作用导致的急性中毒，而例2的死亡原因是三种精神药物作用导致的房室结动脉闭塞导致的致死性心律失常。这两个病例表明，在肥胖的精神病患者中，显微镜下的心肺异常可能是重要的发现，并可能有助于调查死亡方式。在肥胖和/或精神病患者中，这些异常发现的病理机制可能需要进一步的研究。
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 psychiatric 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 hypetrophic 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.