Section: 
From practice
From practiceRevising the issue of acute stenosis of larynx associated with myocardial infarction
А. S. Kiselev (1)
(1) Kirov Military Medical Academy, the Ministry of Defense of Russia, Saint Petersburg, 194044, Russia
UDK: 616.22-007.271:616.127-005.8
DOI: https://doi.org/10.18692/1810-4800-2019-2-103-106
ABSTRACT
The article presents a clinical observation of acute stenosis of the larynx in a patient with bilateral paralysis of the vocal folds of unknown etiology. A few hours after admission and tracheostomy due to the threat of asphyxiation, the patient developed a myocardial infarction, which was fatal. The article describes the dynamics of the patient’s condition, where the classical picture of laryngeal stenosis with a forced sitting position, stridor breathing, retraction of supraclavicular fossae and intercostal spaces first dominated. Despite the hypotension and tachycardia, electrocardiographic signs of myocardial infarction were not detected. The author focuses on the fact that the lack of significant improvement in the patient’s condition, despite the successfully completed tracheostomy, and persistent tachycardia and hypotension could be a sign of the onset of cardiac disorders that had not been detected on the electrocardiogram for a long time. Analyzing this case, originally briefly described in 1984, the author discusses the relationship of bilateral paralysis of the recurrent nerves in stenosis of the larynx with a cardiological disease in the patient and the possible role of excitability of the branches of the vagus nerve, involved in both the innervation of the larynx and the formation of the cardiac plexus. The author emphasizes the importance of the otorhinolaryngologist to keep in mind the possibility of developing myocardial infarction in laryngeal stenosis, despite the complexity of diagnosis and history taking in an emergency situation. The article discusses the importance of involvement of a resuscitator in the event of suspected heart disease or a non-standard postoperative period in acute laryngeal stenosis.
Publication date:
28.03.2019
Keywords:
laryngeal stenosis, myocardial infarction. For citation:
Kiselev A. S. Revising the issue of acute stenosis of larynx associated with myocardial infarction. Rossiiskaya otorinolaringologiya. 2019;18(2):103–106. https://doi.org/ 10.18692/1810-4800-2019-2-103-106