罕见的右内血栓病例报告:一个诊断和抗凝管理挑战
Yangsin Lee1, Shogo Shimada1, Minoru Ono1
1Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
European heart journal. Case reports
|November 19, 2025
概括
抗脂综合征 (APS) 可以导致心室内血栓塞. 这一案例突显了华法林的存在.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 类风湿病学 类风湿病学
背景情况:
- 抗脂综合征 (APS) 是一种罕见的自身免疫性疾病.
- 美国白血病增加了动脉和静脉血栓形成的风险.
- 室内血栓塞可以模仿心脏瘤.
研究的目的:
- 在患有APS的患者中呈现右腹腔内血栓病例.
- 讨论APS中抗凝管理的复杂性.
- 强调在无法解释的血栓形成时考虑APS的重要性.
主要方法:
- 一个54岁的妇女的病例报告,她患有无法解释的脑中风.
- 图像检测显示出一个右心室内质量.
- 手术切除质量,然后进行体质病理学检查.
- 最初使用DOAC进行抗凝血管理,然后使用华法林.
主要成果:
- 组织病理学证实了这种质量是慢性血栓.
- 患者经历了反复的脑中风,尽管DOAC治疗.
- 对APS的诊断被推迟了.
- 华法林在诊断出APS后开始使用.
结论:
- 作为第一个APS事件,诊断心室内血栓是具有挑战性的.
- 在患有无法解释的动脉和静脉血栓症的患者中考虑APS.
- 华法林在APS患者中比DOACs更受青,即使在血栓移除后也是如此.
相关概念视频
Venous Thrombosis III: Interprofessional Care
268
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
268
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
286
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
286
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
277
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
277
Venous Thrombosis IV: Nursing Management
188
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
188
Pulmonary Embolism III: Nursing Management
336
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
336
Venous Thrombosis I: Introduction
321
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
321


