急性肺栓塞与心电图显示左侧主冠状动脉封闭次数:一个病例报告
YanZhang Shu1, BaoLi Xu1, XiaoJia Luo1
1Emergency Department, Chengdu Second People's Hospital, Chengdu, Sichuan, China.
Heliyon
|June 6, 2024
概括
使用心电图,区分急性肺栓塞与急性心肌梗塞是具有挑战性的. 这一案例凸显了侵入性血管造影如何在心电图发现含糊不清时区分这些情况.
科学领域:
- 心脏病学 心脏病学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 在急性肺栓塞 (PE) 中,心电图 (ECG) 的发现可以模仿急性心肌梗塞 (MI),使快速诊断复杂化.
- 区分这些关键条件对于及时和适当的患者管理至关重要.
研究的目的:
- 提出一个ECG发现误导性的案例,需要先进的诊断技术.
- 评估侵袭性冠状动脉和肺血管学在区分PE与左主冠状动脉封闭时的有用性.
主要方法:
- 一名50岁的男性出现了暗示心脏事件的症状.
- 电脑心电图显示了ST段的变化,模仿了左侧主要冠状动脉封闭的亚总.
- 侵袭性冠状动脉血管学显示没有狭窄;随后的肺血管学证实了巨大的双边PE.
主要成果:
- 电脑心电图的发现不足以区分急性PE和次总的左侧冠状动脉封闭.
- 侵袭性冠状动脉血管学排除了冠状动脉狭窄.
- 肺血管造影最终诊断出急性肺栓塞.
结论:
- 在某些情况下,单独使用心电图是不可靠的,以区分急性PE与左主冠状动脉封闭.
- 在血液动力学不稳定的患者中,当超声波延迟时,联合侵入性冠状动脉和肺动脉血管学提供了一个可行的诊断和治疗选择.
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