死性急性胰腺炎与心电图变化掩饰急性冠状动脉综合征
Nirdosh Kumar1, Shahan Waheed1, Amnah Siddiqui1
1Department of Emergency Medicine, Aga Khan University Hospital Karachi, Pakistan.
Oxford medical case reports
|June 28, 2023
概括
末性急性胰腺炎 (NAP) 可以模仿急性冠状动脉综合征 (ACS),带来诊断挑战. 早期识别胰腺酶升高和腹部成像对于准确诊断至关重要.
科学领域:
- 内部医学 内部医学
- 胃肠病学 胃肠病学
- 心脏病学 心脏病学
背景情况:
- 急性胰腺炎 (AP) 是胰腺炎症,其致死性急性胰腺炎 (NAP) 涉及胰腺亡.
- AP可以呈现出类似急性冠状动脉综合征 (ACS) 的症状和心电图 (ECG) 变化.
- 区分AP和ACS可能是一个挑战,特别是在急诊室 (ED) 设置中.
研究的目的:
- 报告一个急性胰腺炎模仿急性冠状动脉综合征的病例.
- 要突出诊断难度在区分这些条件.
主要方法:
- 一个28岁的男性的病例报告显示,他出现了胃上部疼痛,呼吸短促和腹.
- 根据临床表现和暗示ACS的ECG发现进行初始治疗.
- 随后的调查包括冠状动脉血管造影和腹部计算机断层扫描 (CT).
主要成果:
- 最初的心电图显示鼻肌梗塞和不完整的左捆分支堵塞,导致ACS管理.
- 冠状动脉血管图是正常的.
- 血清胰腺酶升高和腹部CT证实了死性急性胰腺炎.
结论:
- 急性胰腺炎,特别是NAP,可以呈现出与心电图表现非常相似的ECG表现.
- 临床警和及时的生化和放射性检查对于ED的准确诊断至关重要.
- 错误的诊断可以通过考虑在患有无法解释的上胃疼痛和心脏症状的患者中考虑AP来避免.
相关概念视频
Acute Coronary Syndrome III: Diagnostic Studies
11
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
11
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
22
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
22
Acute Coronary Syndrome I: Introduction
33
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
33
Electrocardiogram
2.5K
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
2.5K
Acute Coronary Syndrome V: Nursing Management
18
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
18
Acute Coronary Syndrome IV: Interprofessional Care
13
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
13


