Brunson J Matthew, Fine Robert L, Schussler Jeffrey M
Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas, USA.
J Am Soc Echocardiogr. 2009 Sep;22(9):1086.e5-7. doi: 10.1016/j.echo.2009.04.006.
A 79-year-old man with a known ascending aortic aneurysm presented to his physician's office with an episode of severe "tearing" type chest pain after lifting several boxes. Physical examination was notable for low blood pressure and a new diastolic murmur. The patient was transferred to intensive care, and a transthoracic echocardiogram was performed. This demonstrated a dissection flap clearly seen superior to the sinuses of Valsalva and severe aortic insufficiency. Computed tomography or transesophageal echocardiography is typically the initial test of choice, but transthoracic echocardiography can rapidly confirm the diagnosis of acute ascending aortic dissection.
一名79岁的男性，已知患有升主动脉瘤，在搬了几个箱子后出现了一次严重的“撕裂样”胸痛，遂前往医生办公室就诊。体格检查发现血压低且有新出现的舒张期杂音。患者被转入重症监护病房，并进行了经胸超声心动图检查。检查显示在瓦尔萨尔瓦窦上方清晰可见一个夹层瓣，且存在严重的主动脉瓣关闭不全。计算机断层扫描或经食管超声心动图通常是首选的初始检查，但经胸超声心动图可以快速确诊急性升主动脉夹层。
