1 Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, Yonsei University College of Dentistry , Seodaemun-gu, Seoul , South Korea.
2 The Armed Forces Capital Hospital , Bundang-gu, Seongnam-si, Gyeonggi-do , South Korea.
Dentomaxillofac Radiol. 2018 Jul;47(5):20170354. doi: 10.1259/dmfr.20170354. Epub 2018 Apr 13.
This report describes the case of a 52-year-old male patient who exhibited suspicious pulsation patterns during pulpal blood flow assessment using Doppler ultrasound. Initially, he was not aware of his cardiovascular problem; however, after referral to a medical clinic, he was diagnosed with atrial fibrillation. The patient was injured in a motor vehicle accident and referred to our clinic for management of multiple traumatized teeth. On clinical examination, several teeth exhibited negative responses to cold and electrical sensibility tests. For accurate diagnosis, pulpal blood flow assessment using a Doppler ultrasound device was performed. During the tests, irregular pulsation patterns were detected, indicating the possibility of a cardiovascular problem. As he denied any history of cardiovascular problems, he was recommended to visit a medical doctor for further evaluation. The following day, he visited a medical clinic, and a 12-lead electrocardiogram was performed. He was ultimately diagnosed with atrial fibrillation with idioventricular rhythm, and was started on anticoagulant medication for prevention of thrombogenesis, which is a possible complication of atrial fibrillation. As presented in this case, Doppler ultrasound can provide useful information, not only about blood flow in the dental pulp, but also about an individual's pulsation rhythm. When a patient presents with irregular pulsation patterns in certain situations, the possibility of cardiovascular problems should be considered.
本报告介绍了一例 52 岁男性患者,在使用多普勒超声评估牙髓血流时表现出可疑的搏动模式。最初,他并不知道自己存在心血管问题;然而,在转介至医疗诊所后,被诊断为心房颤动。该患者因车祸受伤,被转介至我们的诊所治疗多颗创伤性牙齿。临床检查发现,几颗牙齿对冷和电感觉测试呈阴性反应。为了进行准确的诊断,使用多普勒超声设备进行了牙髓血流评估。在测试过程中,检测到不规则的搏动模式,表明可能存在心血管问题。由于他否认有任何心血管问题的病史,因此建议他去看医生进行进一步评估。第二天,他去了一家医疗诊所,进行了 12 导联心电图检查。最终被诊断为心房颤动伴室性自主节律,并开始使用抗凝药物预防血栓形成,这是心房颤动的一种可能并发症。如本例所示,多普勒超声不仅可以提供有关牙髓血流的有用信息,还可以提供有关个体搏动节律的信息。当患者在某些情况下出现不规则的搏动模式时,应考虑存在心血管问题的可能性。