Daignault Michael C, Saul Turandot, Lewiss Resa E
Department of Emergency Medicine, Emergency Medicine Residency Program, Lincoln Medical & Mental Health Center, Bronx, New York.
Emergency Ultrasound Division, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, New York.
J Emerg Med. 2014 Mar;46(3):373-7. doi: 10.1016/j.jemermed.2013.04.031. Epub 2013 Aug 9.
Thoracic aortic aneurysms (TAAs) are less prevalent than abdominal aortic aneurysms. Symptomatic TAAs need to be identified quickly by the emergency physician (EP) since mortality rates increase dramatically once complications such as rupture or dissection occur. Compared with validated EP-performed ultrasound of the abdominal aorta, EP-performed focused cardiac ultrasound that includes evaluation of the thoracic aorta is relatively unreported.
Two cases illustrate EP-performed focused cardiac ultrasound and evaluation of the thoracic aorta for aneurysmal dilation. CASE
(1) A 60-year-old man presented to the emergency department (ED) after a blunt traumatic injury to his back while at work. During the focused cardiac ultrasound examination, the aortic outflow tract distal to the aortic valve appeared enlarged and the aortic root measured 5.49 cm. (2) An 82-year-old man with hypertension presented to the ED with 1 month of chest pain radiating to the back. The focused cardiac ultrasound examination demonstrated enlargement of the descending thoracic aorta at 4.82 cm.
EPs performing focused cardiac ultrasound can visualize regions of the thoracic aorta that may reveal an aneurysm, particularly in the parasternal long axis view.
胸主动脉瘤（TAA）的发病率低于腹主动脉瘤。有症状的胸主动脉瘤需要急诊医生（EP）迅速识别，因为一旦发生破裂或夹层等并发症，死亡率会急剧上升。与经过验证的急诊医生对腹主动脉进行的超声检查相比，急诊医生进行的包括胸主动脉评估在内的心脏重点超声检查相对较少被报道。
通过两个病例说明急诊医生进行的心脏重点超声检查及对胸主动脉瘤样扩张的评估。
（1）一名60岁男性在工作时背部受到钝性外伤后被送往急诊科（ED）。在心脏重点超声检查中，主动脉瓣远端的主动脉流出道似乎扩大，主动脉根部测量值为5.49厘米。（2）一名82岁患有高血压的男性因胸痛放射至背部1个月而就诊于急诊科。心脏重点超声检查显示胸降主动脉增宽，直径为4.82厘米。
进行心脏重点超声检查的急诊医生可以观察到胸主动脉可能显示动脉瘤的区域，尤其是在胸骨旁长轴视图中。
