Department of Emergency Medicine, University Hospital Basel, Switzerland.
Am J Emerg Med. 2012 Oct;30(8):1662.e1-3. doi: 10.1016/j.ajem.2011.09.004. Epub 2011 Nov 17.
Most commonly, patients with pulmonary embolism present with dyspnea, chest pain, and/or tachypnea to the emergency department (ED). The presence of multiple suggestive symptoms, especially when severe, significantly reduces delay in diagnosis. We report a case of an 86-year-old patient presenting to the ED with nonspecific complaints: she claimed to feel lethargic and “reluctant to prepare meals.” She did not complain of either dyspnea or chest pain. As underlying cause, an intrapulmonary cavitation with pulmonary embolism was found. The combination of absence of specific symptoms regarding pulmonary embolism and radiologic findings of an obstructed pulmonary artery supplying the cavitary lung segment is rare. Common etiologies of cavitary lung processes are discussed, and risk factors of pulmonary infarction are highlighted.
最常见的情况是，肺栓塞患者以呼吸困难、胸痛和/或呼吸急促为主诉到急诊科就诊。当出现多个提示性症状时，尤其是严重症状时，会显著降低诊断的延迟。我们报告了一例 86 岁患者因非特异性症状就诊于急诊科：她声称感到乏力和“不愿意做饭”。她没有出现呼吸困难或胸痛。作为潜在病因，发现了肺内空洞伴肺栓塞。肺栓塞无特异性症状，影像学表现为阻塞性肺动脉供应空洞性肺段的情况较为罕见。本文讨论了空洞性肺部病变的常见病因，并强调了肺梗死的危险因素。
