咳嗽に起因する迷走神経性発作性心房細動の犬の1例
粘液腫様変性性僧帽弁疾患ACVIM Stage Dにて内科的治療中であった10歳のポメラニアンが，発咳後に奇声を発して倒れるとの主訴で来院した。ホルター心電図検査では，発咳後の失神発作に一致して洞停止が11秒間続いた後，心房細動が約1分間持続していた。この洞停止と発作性心房細動が発咳後の失神発作と時期を一にして発生していたことから，神経調節性失神（咳嗽失神）ならびに迷走神経性発作性心房細動と診断された。本例は，ホルター心電図検査が終了した翌日にうっ血性心不全による肺水腫をきたし，入院治療を施したが反応せずに死亡した。心臓の病理組織学的検査において，洞結節を含めた刺激伝導系に著変は認められなかっ...
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| Published in | Dōbutsu no junkanki Vol. 56; no. 2; pp. 101 - 105 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Tokyo
日本獣医循環器学会
2023
Japan Science and Technology Agency |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0910-6537 1883-5260 |
| DOI | 10.11276/jsvc.56.101 |
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| Abstract | 粘液腫様変性性僧帽弁疾患ACVIM Stage Dにて内科的治療中であった10歳のポメラニアンが，発咳後に奇声を発して倒れるとの主訴で来院した。ホルター心電図検査では，発咳後の失神発作に一致して洞停止が11秒間続いた後，心房細動が約1分間持続していた。この洞停止と発作性心房細動が発咳後の失神発作と時期を一にして発生していたことから，神経調節性失神（咳嗽失神）ならびに迷走神経性発作性心房細動と診断された。本例は，ホルター心電図検査が終了した翌日にうっ血性心不全による肺水腫をきたし，入院治療を施したが反応せずに死亡した。心臓の病理組織学的検査において，洞結節を含めた刺激伝導系に著変は認められなかった。 |
|---|---|
| AbstractList | 粘液腫様変性性僧帽弁疾患ACVIM Stage Dにて内科的治療中であった10歳のポメラニアンが，発咳後に奇声を発して倒れるとの主訴で来院した。ホルター心電図検査では，発咳後の失神発作に一致して洞停止が11秒間続いた後，心房細動が約1分間持続していた。この洞停止と発作性心房細動が発咳後の失神発作と時期を一にして発生していたことから，神経調節性失神(咳嗽失神)ならびに迷走神経性発作性心房細動と診断された。本例は，ホルター心電図検査が終了した翌日にうっ血性心不全による肺水腫をきたし，入院治療を施したが反応せずに死亡した。心臓の病理組織学的検査において，洞結節を含めた刺激伝導系に著変は認められなかった。 粘液腫様変性性僧帽弁疾患ACVIM Stage Dにて内科的治療中であった10歳のポメラニアンが，発咳後に奇声を発して倒れるとの主訴で来院した。ホルター心電図検査では，発咳後の失神発作に一致して洞停止が11秒間続いた後，心房細動が約1分間持続していた。この洞停止と発作性心房細動が発咳後の失神発作と時期を一にして発生していたことから，神経調節性失神（咳嗽失神）ならびに迷走神経性発作性心房細動と診断された。本例は，ホルター心電図検査が終了した翌日にうっ血性心不全による肺水腫をきたし，入院治療を施したが反応せずに死亡した。心臓の病理組織学的検査において，洞結節を含めた刺激伝導系に著変は認められなかった。 |
| Author | 平尾, 大樹 末松, 正弘 末松, 弘彰 町田, 登 福島, 隆治 |
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| References | 12） Machida N, Hirakawa A. The anatomical substrate for sick sinus syndrome in dogs. J Comp Pathol. 2021; 189: 125–134. 1） Guglielmini C, Goncalves Sousa M, Baron Toaldo M, Valente C, Bentivoglio V, Mazzoldi C, Bergamin I, Drigo M, Poser H. Prevalence and risk factors for atrial fibrillation in dogs with myxomatous mitral valve disease. J Vet Intern Med. 2020; 34(6): 2223–2231. 9） Keene BW, Atkins CE, Bonagura JD, Fox PR, Häggström J, Fuentes VL. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. J Vet Intern Med. 2019; 33: 1127–40. 10） Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, Cheshire WP, Chelimsky T, Cortelli P, Gibbons CH, Goldstein DS, Hainsworth R, Hilz MJ, Jacob G, Kaufmann H, Jordan J, Lipsitz LA, Levine BD, Low PA, Mathias C, Raj SR, Robertson D, Sandroni P, Schatz I, Schondorff R, Stewart JM, van Dijk JG. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011; 21(2): 69–72. 4） Sriram CS, Naccarelli GV, Luck JC. An atypical case of vagally mediated atrial fibrillation in an elderly woman: electrocardiographic caveats to diagnosis. J Electrocardiol 2014; 47(5): 734–737. 11） Țentea CP, Eötvös CA, Lazar RD, Paștiu G, Zehan IG, Andrei MG, Porca A, Jelnean M, Chiorescu RM, Mocan-Hognogi LD, Pop S. Electrocardiographic patterns in patients with neurally mediated syncope. Blendea D.Medicina (Kaunas). 2021; 57(8): 808. 7） Johnson MS, Martin MW, Henley W. Results of pacemaker implantation in 104 dogs. J Small Anim Pract. 2007; 48(1): 4–11. 6） Fukushima R, Araie T, Itou N, Kawaguchi T, Yamada S, Yoshimura A, Goya S, Shimada K, Uchide T, Kishimoto M, Machida N. Canine case of swallowing syncope that improved after pacemaker implantation. J Vet Med Sci. 2018 24; 80(3): 460–464. 2） Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006; 114: e257–354. 13） Liu L, Nattel S, Differing sympathetic and vagal effects on atrial fibrillation in dogs: role of refractoriness heterogeneity. Am J Physiol. 1997; 273: H805–H816. 5） Kato H, Masutani S, Hoshiyama M,Shibuya K, Isoda K, Hishi T, Murakawa Y, Yanagisawa M. Neurally mediated syncope complicated with paroxysmal atrial fibrillation. Acta Paediatr Jpn. 1996; 38(6): 695–698. 8） Porteiro Vázquez DM, Perego M, Santos L, Gerou-Ferriani M, Martin MW, Santilli RA. Paroxysmal atrial fibrillation in seven dogs with presumed neurally-mediated syncope. J Vet Cardiol. 2016; 18(1): 1–9. 3） 山下武志．心房細動と副交感神経比較．心電図研究会2003年23巻Suppl 1号：45–49 |
| References_xml | – reference: 5） Kato H, Masutani S, Hoshiyama M,Shibuya K, Isoda K, Hishi T, Murakawa Y, Yanagisawa M. Neurally mediated syncope complicated with paroxysmal atrial fibrillation. Acta Paediatr Jpn. 1996; 38(6): 695–698. – reference: 12） Machida N, Hirakawa A. The anatomical substrate for sick sinus syndrome in dogs. J Comp Pathol. 2021; 189: 125–134. – reference: 2） Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006; 114: e257–354. – reference: 6） Fukushima R, Araie T, Itou N, Kawaguchi T, Yamada S, Yoshimura A, Goya S, Shimada K, Uchide T, Kishimoto M, Machida N. Canine case of swallowing syncope that improved after pacemaker implantation. J Vet Med Sci. 2018 24; 80(3): 460–464. – reference: 4） Sriram CS, Naccarelli GV, Luck JC. An atypical case of vagally mediated atrial fibrillation in an elderly woman: electrocardiographic caveats to diagnosis. J Electrocardiol 2014; 47(5): 734–737. – reference: 13） Liu L, Nattel S, Differing sympathetic and vagal effects on atrial fibrillation in dogs: role of refractoriness heterogeneity. Am J Physiol. 1997; 273: H805–H816. – reference: 1） Guglielmini C, Goncalves Sousa M, Baron Toaldo M, Valente C, Bentivoglio V, Mazzoldi C, Bergamin I, Drigo M, Poser H. Prevalence and risk factors for atrial fibrillation in dogs with myxomatous mitral valve disease. J Vet Intern Med. 2020; 34(6): 2223–2231. – reference: 7） Johnson MS, Martin MW, Henley W. Results of pacemaker implantation in 104 dogs. J Small Anim Pract. 2007; 48(1): 4–11. – reference: 8） Porteiro Vázquez DM, Perego M, Santos L, Gerou-Ferriani M, Martin MW, Santilli RA. Paroxysmal atrial fibrillation in seven dogs with presumed neurally-mediated syncope. J Vet Cardiol. 2016; 18(1): 1–9. – reference: 9） Keene BW, Atkins CE, Bonagura JD, Fox PR, Häggström J, Fuentes VL. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. J Vet Intern Med. 2019; 33: 1127–40. – reference: 11） Țentea CP, Eötvös CA, Lazar RD, Paștiu G, Zehan IG, Andrei MG, Porca A, Jelnean M, Chiorescu RM, Mocan-Hognogi LD, Pop S. Electrocardiographic patterns in patients with neurally mediated syncope. Blendea D.Medicina (Kaunas). 2021; 57(8): 808. – reference: 10） Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, Cheshire WP, Chelimsky T, Cortelli P, Gibbons CH, Goldstein DS, Hainsworth R, Hilz MJ, Jacob G, Kaufmann H, Jordan J, Lipsitz LA, Levine BD, Low PA, Mathias C, Raj SR, Robertson D, Sandroni P, Schatz I, Schondorff R, Stewart JM, van Dijk JG. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011; 21(2): 69–72. – reference: 3） 山下武志．心房細動と副交感神経比較．心電図研究会2003年23巻Suppl 1号：45–49 |
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| Snippet | 粘液腫様変性性僧帽弁疾患ACVIM Stage Dにて内科的治療中であった10歳のポメラニアンが，発咳後に奇声を発して倒れるとの主訴で来院した。ホルター心電図検査では，発咳... |
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| SubjectTerms | 心房細動 犬 神経調節性失神 迷走神経 |
| Title | 咳嗽に起因する迷走神経性発作性心房細動の犬の1例 |
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