在心脏转变之前的跨食道心声图在心房患者的心脏转变前
Victor O Adedara1, Vagisha Sharma2, Hassan Nawaz3
1Medicine, St. George's University School of Medicine, St. George's, GRD.
Cureus
|July 3, 2023
概括
对于心房动 (AF) 进行心脏转换前的透食管回声心电图 (TEE) 有助于识别血栓,降低中风风险. 然而,血栓塞栓事件仍然可能发生,强调需要继续抗凝药和进一步研究.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 临床实践 临床实践
背景情况:
- 心房动 (AF) 是一种常见的心律失常症,并有严重的并发症.
- 心脏转移经常用于对药物不反应的AF患者.
- 在AF患者心脏转变之前,经食道心声学 (TEE) 的作用尚未完全确定.
研究的目的:
- 在AF患者心脏转移前对TEE使用的当前文献进行审查.
- 综合了解心转前TEE的好处和局限性.
- 为临床实践提供实用建议,用于管理心脏转换的AF患者.
主要方法:
- 用关键词对数据库进行文献搜索:"心脏动"",心脏转变"和"食道间心声谱".
- 包括/排除标准和质量评估适用于640篇最初的文章,最终产生了20篇论文 (7篇追溯,12篇前性观察,1篇RCT).
主要成果:
- 左心房血栓 (LAT) 是心脏转变的禁忌;心房污泥是相对禁忌.
- TEE可以检测血栓,有助于风险分层和减少栓塞事件,特别是通过对比度增强.
- 即使没有检测到血栓,心转变后也可能发生血栓栓塞事件;心房麻醉是潜在的危险因素.
结论:
- 建议使用TEE引导的心脏转变,特别是在门诊环境中,以检测心房血栓.
- 治疗性抗凝剂在心脏转变期间和之后至关重要,无论TEE的发现如何.
- 需要进一步的研究来澄清TEE在检测心房麻醉中的作用及其对未来血栓塞栓事件的影响.
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