肺栓塞症の患者におけるシンコープ
JAMA
|December 5, 1977
まとめ
失眠は,急性肺栓塞 (PE) 症例の13%で重要な症状です. PEの早期診断には,動脈血中ガス分析や肺スシンチグラフィーのような検査を用いて,一時的な低血圧を超えて追加のヒントを探求する必要があります.
科学分野:
- 心臓病学 心臓病学
- 肺内科 肺内科 肺内科
- 緊急医療 緊急医療
背景:
- 急性肺栓塞 (PE) の提示症状としてのは,しばしば見過ごされます.
- 大規模なPEは一時的な低血圧を引き起こし,失眠を他の原因に誤って割り当てる可能性があります.
- PEの正確な診断には,臨床的表情と診断検査を慎重に検討する必要があります.
研究 の 目的:
- 急性肺栓塞 (PE) の主要な症状としてのの頻度を調査する.
- シンコペとして現れるPEに関連した診断上の課題を強調する.
- PEが疑われる場合,さらなる診断ヒントを探すことの重要性を強調する.
主な方法:
- 急性肺栓塞 (PE) の132件の連続した症例の遡及的レビュー.
- PEのドキュメントは,肺血管撮影によって確認されました.
- シンコペの発生率に焦点を当てた臨床的特徴の分析.
主要な成果:
- シンコペは,レビューされたPE症例の17 (13%) で初期または主たる臨床的特徴でした.
- PE後の一時的な低血圧は自発的に解消し,診断を複雑にする可能性があります.
- PEの診断は,シンコープを呈する入院していない患者で頻繁に見逃されます.
結論:
- 昏睡は,急性肺栓塞 (PE) の重要な症状である可能性があります.
- PEの診断評価は,シンコープの患者,特に他の示唆的な手がかりがある場合,考慮されるべきです.
- 動脈血ガス測定と肺スシンチグラフィは,シンコップが顕著な特徴であるとき,PEを診断するための貴重なツールです.
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