急性胰腺炎呈现为心肌下壁缺血症:一个病例报告
Inês Ferreira1, Inês Fiúza M Rua1, Diogo Ramos1
1Internal Medicine, Unidade Local de Saúde São José, Lisbon, PRT.
Cureus
|October 8, 2025
概括
急性胰腺炎可以模仿心脏病发作,导致心电图上ST段升高. 这种罕见的胰腺炎很难诊断,需要仔细的临床评估来区分与急性冠状动脉综合征.
科学领域:
- 心脏病学 心脏病学
- 胃肠病学 胃肠病学
- 内部医学 内部医学
背景情况:
- 急性胰腺炎通常会导致腹部疼痛.
- 胰腺炎可能导致心电图 (ECG) 异常,原因是胰腺和心脏的接近.
- 模仿ST段升高的急性冠状动脉综合征 (ACS) 是胰腺炎的罕见心电图发现.
研究的目的:
- 呈现一种急性胰腺炎的病例,模仿ST升高心肌梗塞 (STEMI).
- 要突出诊断的挑战在区分胰腺炎诱导的心电图变化从真正的ACS.
- 强调临床意识和报告这种罕见病例的重要性.
主要方法:
- 一个92岁的男性患者的病例报告.
- 临床表现与上胃疼痛和心电图发现表明下壁STEMI.
- 诊断工作,包括血液检查,最终诊断为死血性胰腺炎.
主要成果:
- 患者的心电图最初被解释为对下壁STEMI的关注,促使其接受血管塑性手术.
- 完整的血液检查揭示了潜在的死性胰腺炎,与稳定的冠状动脉疾病.
- 尽管用液体,血管压缩剂和抗生素治疗,但不幸的是,患者在入院48小时后死亡.
结论:
- 这个案例说明了STEMI和胰腺炎之间罕见而难以区分的情况,这些病例呈现出类似ACS的心电图变化.
- 在这种情况下,临床警对于准确的诊断和适当的管理至关重要.
- 报告这些病例有助于提高认识,完善诊断和治疗策略.
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