Kiernan T J
Int J Cardiol. 2007 Jan 8;114(2):E77-8. doi: 10.1016/j.ijcard.2006.07.043. Epub 2006 Oct 17.
A 73-year-old woman with previous coronary artery bypass grafting presented with acute pleuritic type chest pain, decreased oxygen saturations and markedly elevated D-dimers. Acute pulmonary embolism was suspected and because of hypotension an emergency transthoracic echocardiogram was performed to assess pulmonary hypertension. This revealed an acute type A aortic dissection. This case highlights the importance of transthoracic echocardiography as a simple noninvasive tool in the evaluation of chest pain. It also highlights more importantly the relationship of acute aortic dissection and elevated D-dimers which is of tremendous significance to the practising clinician when it comes to patient care and safety.
一名曾接受冠状动脉旁路移植术的73岁女性，出现急性胸膜炎样胸痛、氧饱和度下降和D-二聚体显著升高。怀疑为急性肺栓塞，由于患者出现低血压，遂进行急诊经胸超声心动图检查以评估肺动脉高压。结果显示为急性A型主动脉夹层。该病例凸显了经胸超声心动图作为评估胸痛的一种简单无创工具的重要性。更重要的是，它还凸显了急性主动脉夹层与D-二聚体升高之间的关系，这对于临床医生在患者护理和安全方面具有极其重要的意义。
