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表现为ST段抬高的医源性右侧气胸：一例罕见病例报告及文献复习

Iatrogenic Right-Sided Pneumothorax Presenting as ST-Segment Elevation: A Rare Case Report and Review of Literature.

作者信息

Alzghoul Bashar, Innabi Ayoub, Shanbhag Anusha, Chatterjee Kshitij, Amer Farah, Meena Nikihil

机构信息

Department of Internal Medicine, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA.

Faculty of Medicine, University of Jordan, Amman, Jordan.

出版信息

Case Rep Crit Care. 2017;2017:3291751. doi: 10.1155/2017/3291751. Epub 2017 Mar 26.

DOI:10.1155/2017/3291751
PMID:28458928
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5385216/
Abstract

Pneumothorax is a well-recognized complication of central venous line insertion (CVL). Rarely, pneumothorax can lead to electrocardiogram (ECG) findings mimicking ST-segment elevation myocardial infarction. We present a 63-year-old man with iatrogenic right-sided pneumothorax who developed ST-segment elevation on a 12-lead ECG suggestive of myocardial infarction. The ECG findings completely resolved after needle decompression and chest tube placement. This case points up this rare electrocardiographic finding with discussion of possible mechanisms and differential diagnosis.

摘要

气胸是中心静脉置管（CVL）一种公认的并发症。气胸极少会导致心电图（ECG）表现酷似ST段抬高型心肌梗死。我们报告一名63岁男性，因医源性右侧气胸在12导联心电图上出现提示心肌梗死的ST段抬高。在进行针吸减压和放置胸管后，心电图表现完全消失。本文通过讨论可能的机制和鉴别诊断指出了这一罕见的心电图表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0973/5385216/bd5468da6019/CRICC2017-3291751.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0973/5385216/2234e049d654/CRICC2017-3291751.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0973/5385216/bd5468da6019/CRICC2017-3291751.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0973/5385216/2234e049d654/CRICC2017-3291751.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0973/5385216/bd5468da6019/CRICC2017-3291751.002.jpg

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本文引用的文献

1
Central line complications.中心静脉置管并发症。
Int J Crit Illn Inj Sci. 2015 Jul-Sep;5(3):170-8. doi: 10.4103/2229-5151.164940.
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Intravascular Complications of Central Venous Catheterization by Insertion Site.经插入部位的中心静脉导管相关的血管内并发症
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Left spontaneous pneumothorax presenting with ST-segment elevations: a case report and review of the literature.左侧自发性气胸伴 ST 段抬高：病例报告及文献复习。
由于乳糜胸导致的可逆性、区域性 ST 段抬高。
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Electrocardiographic changes in patients with spontaneous pneumothorax.
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Am Heart J. 1982 Feb;103(2):303-5. doi: 10.1016/0002-8703(82)90509-9.
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Left tension pneumothorax mimicking myocardial ischemia after percutaneous central venous cannulation.经皮中心静脉置管后酷似心肌缺血的左侧张力性气胸
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10
Transient ST elevation associated with tension pneumothorax.与张力性气胸相关的短暂性ST段抬高。
JACEP. 1979 Jan;8(1):16-8. doi: 10.1016/s0361-1124(79)80442-6.