高血圧を契機とした急性心不全の一例

Abstract

症例，58歳の女性．慢性腎臓病を伴う高血圧を他院で加療中，夜間突然の呼吸苦で救急搬送された．左室駆出率（left ventricular ejection fraction：LVEF ）20% と高度の低左心機能を認め，著明な高血圧と急性呼吸不全を伴うクリニカルシナリ オ1の心不全のため人工呼吸器管理となった．その後，速やかに肺うっ血は改善されガイドラインに基づいた心不全治療が2週 間以内に達成され，高血圧コントロールをすることにより，早期退院とLVEFの早期回復が可能となった症例を経験した．

We experienced a case in a 58-year-old female who was transported to the emergency department after sudden respiratory distress at night while under treatment at another clinic for hypertension due to chronic renal disease. The left ventricular ejection fraction (LVEF) was 20%, which indicated poor left heart function, and the patient was put under ventilator management for heart failure at clinical scenario 1 accompanied by marked hypertension and acute respiratory failure. The pulmonary congestion mitigated rapidly by the management. Treatment of heart failure was completed according to the guidelines within 2 weeks. LVEF soon improved and the patient was discharged from the hospital early after control of hypertension.