【摘要】 心室颤动(VF)是常见的急危重症。寻找VF的病因对后续诊疗十分关键，其最常见的病因包括急性冠状动脉综合征、心力衰竭、心肌病和离子通道病等。本文报道1例由氟乙酸中毒引起的VF,患者为男性，35岁，主因“胸闷10小时，意识丧失2小时”于2022年9月21日就诊于北京大学第三医院。患者接触可疑毒物后出现胸闷，伴言语不清，乏力，继之突发意识丧失，心电图提示为VF、室性心动过速和部分导联ST段抬高，伴有心肌损伤标记物升高，超声心动图提示左、右室收缩功能下降，经一系列检查提示上述临床表现由氟乙酸中毒引起，经血液灌流和解毒剂乙酰胺治疗后逐渐好转。该病例报道提示在VF病因鉴别诊断中应考虑毒物或药物中毒，特别在患者可能接触有毒物质时。更多还原

【Abstract】 Ventricular fibrillation(VF) is a common critical disease. The reason for VF is crucial for subsequent treatment. The common reasons for VF include acute coronary syndrome, heart failure, cardiomyopathy, and ion channel disease. This paper reports a case of VF caused by fluoroacetate poisoning. The patient, a 35-year-old man, was admitted to Peking University Third Hospital on September 21st, 2022 due to "chest tightness for 10 hours and loss of consciousness for 2 hours". After exposure to the suspected poison, the patient developed chest tightness, accompanied by slurred speech, fatigue, and subsequent sudden loss of consciousness. The electrocardiogram indicated VF, ventricular tachycardia, and ST segments elevation in some leads, elevated markers of myocardial injury. And the echocardiography showed the decline of left and right ventricular systolic function. A series of examinations indicated that the above manifestations were caused by fluoroacetate poisoning, and the patient recovered through hemofiltration and acetamide treatment. The case suggests that poisoning should be included in the differential diagnosis of the cause of VF, especially when patients have suspected exposure to toxic substances.更多还原