Kwak K D, Mosher S F, Willis C L, Kimura B J
Department of Internal Medicine, Scripps-Mercy Hospital, San Diego, CA, USA.
Chest. 1999 May;115(5):1462-4. doi: 10.1378/chest.115.5.1462.
A patient with chronic lung disease and a right atrial density that was difficult to distinguish on a transthoracic echocardiogram underwent transesophageal echocardiography (TEE) that demonstrated two mobile masses attached to the anterior right atrial wall. During the TEE procedure, the patient experienced coughing and retching due to the esophageal intubation, and the embolization of one of the right atrial masses was observed. This case is the first to document this mechanism of pulmonary embolism (a mechanism that was suspected in two prior reports), and it questions the safety of procedures that induce retching and coughing in patients with mobile right atrial masses.
一名患有慢性肺部疾病的患者，其右心房密度在经胸超声心动图上难以区分，遂接受了经食管超声心动图（TEE）检查，结果显示有两个活动的肿块附着于右心房前壁。在TEE检查过程中，患者因食管插管出现咳嗽和干呕，并观察到右心房肿块之一发生了栓塞。该病例首次记录了这种肺栓塞机制（在之前的两份报告中曾怀疑有这种机制），并对在有活动右心房肿块的患者中诱发干呕和咳嗽的操作安全性提出了质疑。
