一个毁灭性的撕裂:在心声扫描上发现的大动脉剖析的非典型呈现
Saleh Alhalaseh1, Salomon Chamay1, Nelson Barrera1
1Internal Medicine, SBH (St. Barnabas Hospital) Health System, Bronx, USA.
Cureus
|July 3, 2023
概括
由于各种症状,诊断急性大动脉解剖 (AAD) 是一个挑战. 这一案例突出了微妙的呈现,强调了在识别这种危及生命的疾病时需要保持警.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
- 紧急医疗 紧急医疗
背景情况:
- 急性大动脉解剖 (AAD) 是一种危急的情况,需要快速诊断以预防死亡.
- 患有AAD的临床表现非常可变,往往缺乏像脉冲缺陷或声这样的经典症状.
- 微妙或非典型的症状可以显著延迟诊断和治疗.
研究的目的:
- 要突出与急性大动脉剖析相关的诊断挑战.
- 呈现一种非典型呈现的AAD病例.
- 强调高级成像在确认AAD中的重要性.
主要方法:
- 一个病人的病例报告,患有急性下侧胸痛和低血压.
- 最初的护理点超声波 (POCUS) 评估心周溢出.
- 随访心声图以评估大动脉的剖析.
主要成果:
- 患者出现过渡性胸痛和低血压,没有典型的AAD症状.
- 波克斯 (POCUS) 发现了一个小的心周溢液.
- 心声图证实了上升的大动脉和大动脉根扩张,诊断了AAD.
结论:
- 当经典症状不存在时,AAD诊断可能很困难.
- 非典型的呈现需要高度的怀疑指数和迅速的成像.
- 心声谱对于绝对诊断大动脉剖析至关重要.
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