DeZorzi Christopher, Harris Katherine I
University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Case Rep Cardiol. 2018 Jun 6;2018:8628365. doi: 10.1155/2018/8628365. eCollection 2018.
This case presentation discusses an extremely rare diagnosis presenting with common symptoms, attributed to influenza, which were not investigated further when clear cardiac symptoms developed. The patient initially presented with symptoms consistent with influenza, but when orthopnea and dyspnea on exertion developed, these cardiac symptoms continued to be attributed to a postviral syndrome and were not further evaluated. Premature closure bias contributed to a delay in diagnosing a rare cardiac condition. The diagnostic momentum, or the continuing of a diagnostic label, occurred across multiple providers and settings. This case demonstrates the risk of premature closure and diagnostic momentum and reminds clinicians to reframe the differential diagnosis as more information on history or physical exam becomes available.
本病例报告讨论了一种极为罕见的诊断情况，该病例以常见症状发病，最初被归因于流感，在出现明确的心脏症状后未作进一步检查。患者最初表现出与流感相符的症状，但当出现端坐呼吸和劳力性呼吸困难时，这些心脏症状仍被归因于病毒感染后综合征，未作进一步评估。过早闭合偏差导致了一种罕见心脏疾病诊断的延迟。诊断惯性，即持续使用同一诊断标签，在多个医疗人员和场所中出现。本病例展示了过早闭合和诊断惯性的风险，并提醒临床医生，随着病史或体格检查获得更多信息，应重新构建鉴别诊断。
