肺血栓栓塞症患者体内游走性右心血栓。
Right cardiac thrombus in transit among patients with pulmonary thromboemboli.
机构信息
Cardiology Department, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran.
出版信息
Clin Cardiol. 2009 Jun;32(6):E27-31. doi: 10.1002/clc.20386.
BACKGROUND
This study was designed to investigate the prevalence, clinical and laboratory findings, and short-term prognostic significance of mobile right cardiac thrombus (MRCT) among patients with pulmonary thromboembolism (PTE).
METHODS
From January 2004 to November 2006, 12 of 100 patients admitted with a diagnosis of PTE had an MRCT. Diagnosis of in-transit right-sided thrombi was made when a wormlike elongated mass was detected. The primary end point was comparison of the mortality rate of MRCT (+) patients with that of MRCT (-) patients for an average of 8 months of follow-up. The secondary end points were comparison of clinical and laboratory data between these 2 groups.
RESULTS
All MRCT (+) patients but 1 had dyspnea, but just 2 patients had syncope during exertion. The most frequent electrocardiographic finding was T inversion in leads V1-V3 (75%). All 6 of the MRCT (+) patients who had a cardiac arrest in the hospital died in the hospital. In comparison, of the 88 MRCT (-) patients, 12 had a cardiorespiratory arrest, 4 of whom survived (hospital mortality rate of 50% versus 9%, respectively).
CONCLUSIONS
It seems that the presence of MRCT has prognostic significance, predicting a higher-than-average mortality rate.
背景
本研究旨在探讨肺血栓栓塞症（PTE）患者中移动性右心血栓（MRCT）的患病率、临床和实验室发现及短期预后意义。
方法
2004 年 1 月至 2006 年 11 月期间，100 例诊断为 PTE 的患者中有 12 例存在 MRCT。当检测到虫样伸长的肿块时，即可诊断为正在迁徙的右侧血栓。主要终点是比较平均随访 8 个月时 MRCT（+）患者与 MRCT（-）患者的死亡率。次要终点是比较这两组患者的临床和实验室数据。
结果
所有 MRCT（+）患者均有呼吸困难，但仅 2 例在活动时出现晕厥。最常见的心电图表现为 V1-V3 导联 T 波倒置（75%）。所有 6 例在医院发生心脏骤停的 MRCT（+）患者均在医院死亡。相比之下，88 例 MRCT（-）患者中有 12 例发生心肺骤停，其中 4 例存活（医院死亡率分别为 50%和 9%）。
结论
似乎存在 MRCT 具有预后意义，预测死亡率高于平均水平。
Zotero 插件