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慢性病患者早期主要不良心血管事件:一个病例报告
Saleh Saleh Juman Alseiari1, Reem Fadil Ali Al Thehli1, Munawar Farooq2
1Department of Emergency Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE.
Cureus
|July 11, 2023
概括
在慢性病患者中诊断心肌梗塞是很困难的,因为高水平的托罗. 慢性脏病患者中微小的热素变化可能表明有重大心脏事件,需要仔细评估.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 急性冠状动脉综合征 (ACS) 在慢性病 (CKD) 患者中提出了独特的诊断挑战.
- 在CKD中基线热素水平升高使心肌梗塞 (MI) 的诊断复杂化.
- 目前的指导方针缺乏临床上显著的肌素变化临床上显著的肌素变化临床上显著的临床上显著的肌素变化.
研究的目的:
- 要突出诊断困难在慢性脏病患者中识别心肌梗塞.
- 为了强调潜在的低估心脏事件,由于CKD中非典型的热素模式.
主要方法:
- 一个患有CKD和胸痛的患者的病例报告介绍.
- 对托罗邦水平的分析,包括基线和三角形变化.
- 临床表现的审查,急诊室的过程,以及随后的心脏事件.
主要成果:
- 一名患有CKD和基线升的热血素的患者经历了显著的ST-升高心肌梗塞 (STEMI),尽管热血素三角变化很小 (11%).
- 由于血液动力学不稳定和急性心力衰竭,患者需要紧急干预,包括输管和冠状动脉再血管化.
- 初步的急诊室出院用于门诊随访证明是不充分的.
结论:
- 在基线水平升高的CKD患者中,托罗宁的小百分比变化可能具有临床意义.
- 迫切需要更新的指导方针,以在CKD患者群体中管理疑似心肌梗塞.
- 这一案例突显了急诊室评估慢性病患者ACS的方案中的差距.
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