Chang JH. Tseng CF. Wang JY. Hypoglycemia-induced myocardial infarction: an unusual adverse effect of sulfonylureas. [Case Reports. Letter] International Journal of Cardiology. 115(3):414-6, 2007 Feb 14.
我報告講這篇case~被老師ㄉㄧㄤ半天
不過機轉的部份老師倒是沒有別的comment
case倒是ㄉㄧㄤ到不行 ....哈哈
Myocardial "ischemia" v.s hypoglycemia
Myocardial ischemia is characterized by an imbalance
between myocardial oxygen supply and demand. Hypoglycemia is known to produce sympathetic discharge that may increase heart rate, ventricular afterload, and the inotropic state of the myocardium, with a resulting increase in
myocardial oxygen consumption. Hypoglycemia also causes the release of counter-regulatory hormones, such as
glucagon, epinephrine, norepinephrine, cortisol, and growth
hormone. These catecholamines have the greatest immediate
cardiovascular effect because they increase myocardial
oxygen demand and may also decrease coronary blood
supply by promoting coronary vasoconstriction at the sites of
coronary stenosis.
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