Hypomagnésémie avec Torsades de Pointe dans les Suites d’un Pontage Aorto-Coronarien

Joseph Koné, Mohammed Amine El Bouaychi, Fayçal Elkennassi, Guy Tsala, Adil Bensouda

Abstract


Le magnésium est un ion régulateur des canaux K+, Na+ et Ca++ au niveau de la cellule myocardique, et son activité anti-arythmique est bien connue, notamment dans le traitement des troubles du rythme supra ventriculaires, ventriculaires et les torsades de pointes. Le déficit en magnésium se manifeste par des désordres électrolytiques, des signes neuromusculaires et cardiovasculaires pouvant engager le pronostic vital. Le traitement repose sur la supplémentation intraveineuse et per os. En périopératoire de chirurgie cardiaque, la survenue de l’hypomagnésémie est multifactorielle et sa responsabilité dans la genèse des complications postopératoires doit être prise en compte. Dans l’objectif de rappeler l’importance du magnésium chez ces patients, nous rapportons un cas de torsades de pointe par hypomagnésémie survenue en postopératoire d’un triple pontage aorto-coronarien chez un patient diabétique de 63 ans.

ABSTRACT
Magnesium is one of the important ion the regulation of K+, Na+ et Ca++ channels interfering with the myocardial cell, and its anti-arrhythmic activity is well documented as well in the treatment of ventricular and supra-venticular rhythm disorders and torsades de pointe. The clinical manifestations of magnesium deficiency are electrolytic disorders, neuromuscular and cardiovascular symptoms which may be life threatening. The treatment Intravenous and oral supplementation is the treatment.
In perioperative course of cardiac surgery, the occurrence of hypomagnesemia is multifactorial and its responsibility in postoperative outcomes may be taken in account. Authors aimed to remember the relevance of blood magnesium level in these patients, and report a case of torsades de pointe occurred after a coronary by-pass graft in a 36 years old patient.


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