大规模双边肺血栓塞栓症由于血栓过渡到右心室:一个病例报告
Sharon Hefziba Pineda Guevara1,2, César Alas-Pineda3,4, Carlos Alvarado5
1Department of Internal Medicine, Dr. Mario Catarino Rivas National Hospital, San Pedro Sula, HND.
Cureus
|February 18, 2026
概括
诊断并治疗了一种罕见的穿越性血栓与肺栓塞 (PE) 的病例. 床边回声心脏成像对于在资源有限的环境中及时诊断和管理至关重要,改善了患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 肺血栓塞栓症 (PTE) 是一种严重的疾病,通常需要快速诊断.
- 在PTE旁边的过境血栓呈现出一种罕见和新兴的临床情景.
- 资源有限的环境对诊断和管理PTE等关键条件提出了独特的挑战.
研究的目的:
- 报告一个带有过境血栓的PTE病例.
- 突出床边回声心脏学在在资源有限的环境中诊断PTE的实用性.
- 强调及时抗凝药在应对这种紧急情况时的重要性.
主要方法:
- 一名48岁的男性患者出现呼吸障碍.
- 双边PTE和右心房血栓的诊断通过胸部CT和胸前心脏回声学得到证实.
- 治疗包括治疗性抗凝剂.
主要成果:
- 胸部CT证实了双边PTE与右肺动脉封闭和左肺动脉狭窄.
- 胸外心声扫描发现了显著的右心房血栓.
- 随访心声扫描显示血栓减少,患者在抗凝剂下出院.
结论:
- 早期诊断和治疗带有中转血栓的PTE至关重要.
- 床边回声心脏图像是资源有限的环境中快速诊断的宝贵工具.
- 有效的抗凝药可以在复杂的PTE病例中带来有利的结果.
相关概念视频
Pulmonary Embolism I: Introduction
897
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
897
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
511
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...
511
Venous Thrombosis I: Introduction
504
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...
504
Pulmonary Embolism III: Nursing Management
470
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...
470
Cardiac Catheterization II: Right Heart Catheterization
1.2K
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
1.2K
Venous Thrombosis III: Interprofessional Care
388
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...
388


