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卵圆孔未闭导致的急性心肌梗死合并肺栓塞

Acute myocardial infarction with concomitant pulmonary embolism as a result of patent foramen ovale.

作者信息

Hayıroğlu Mert İlker, Bozbeyoğlu Emrah, Akyüz Şükrü, Yıldırımtürk Özlem, Bozbay Mehmet, Bakhshaliyev Nijad, Renda Emir, Gök Gülay, Eren Mehmet, Pehlivanoğlu Seçkin

机构信息

Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.

Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.

出版信息

Am J Emerg Med. 2015 Jul;33(7):984.e5-7. doi: 10.1016/j.ajem.2014.12.025. Epub 2015 Jan 16.

Abstract

Acute myocardial infarction (MI) and pulmonary embolism canal one lead to life-threatening conditions such as sudden cardiac death and congestive heart failure. We discuss a case of a 74-year-old man presented to the emergency department with acute dyspnea and chest pain. Acute anterior MI and pulmonary embolism concomitantly were diagnosed. Primary percutaneous coronary intervention performed because of preliminary acute anterior MI diagnosis. Transthoracic echocardiography was performed to determine further complications caused by acute MI because patient had a continuous tachycardia and dyspnea although hemodynamically stable. Transthoracic echocardiography revealed a thrombus that was stuck into the patent foramen ovale with parts in right and left atria. Anticoagulation therapy was started; neither fibrinolytic therapy nor operation was performed because of low survey expectations of the patient's recently diagnosed primary disease stage IV lung cancer. Patient was discharged on his 20th day with oral anticoagulation and antiagregant therapy.

摘要

急性心肌梗死(MI)和肺栓塞都可能导致危及生命的情况,如心源性猝死和充血性心力衰竭。我们讨论一例74岁男性患者,因急性呼吸困难和胸痛就诊于急诊科。诊断为急性前壁心肌梗死和肺栓塞并存。由于初步诊断为急性前壁心肌梗死,故进行了急诊经皮冠状动脉介入治疗。因患者虽血流动力学稳定,但持续心动过速和呼吸困难,故行经胸超声心动图检查以确定急性心肌梗死引起的进一步并发症。经胸超声心动图显示有一血栓嵌顿于卵圆孔未闭,部分位于右心房和左心房。开始抗凝治疗;由于对患者最近诊断的IV期原发性肺癌预期生存期较低,未进行溶栓治疗或手术。患者在第20天出院,接受口服抗凝和抗血小板治疗。

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