即时超声诊断伴有移动血栓的肺栓塞
Point-of-care Ultrasound Diagnosis of Pulmonary Embolism with Thrombus in Transit.
作者信息
Kahl Nicolas, Gabriel Christopher, Lahham Shadi, Thompson Maxwell, Hoonpongsimanont Wirachin
机构信息
University of California, Irvine, Department of Emergency Medicine, Orange, California.
出版信息
Clin Pract Cases Emerg Med. 2019 Jan 4;3(1):11-12. doi: 10.5811/cpcem.2018.11.40377. eCollection 2019 Feb.
A 95-year-old female with a history of dementia and atrial fibrillation (not on anticoagulation) presented to the emergency department (ED) by ambulance from her skilled nursing facility due to hypoxia. Point-of-care ultrasound was performed, and showed evidence of a large mobile thrombus in the right ventricle on apical four-chamber view. Further evidence of associated right heart strain was seen on the corresponding parasternal short-axis view. These ultrasound findings in combination with the patient's clinical presentation are diagnostic of acute pulmonary embolism with right heart strain. Point-of-care transthoracic cardiac ultrasound in the ED is an effective tool to promptly diagnose acute pulmonary embolism with right heart strain and thrombus in transit and guide further treatment.
一名95岁女性，有痴呆症和心房颤动病史（未接受抗凝治疗），因缺氧从其熟练护理机构由救护车送往急诊科（ED）。进行了床旁超声检查，在心尖四腔视图上显示右心室有一个大的活动血栓。在相应的胸骨旁短轴视图上可见右心劳损的进一步证据。这些超声检查结果与患者的临床表现相结合，可诊断为伴有右心劳损的急性肺栓塞。急诊科的床旁经胸心脏超声是一种有效的工具，可迅速诊断伴有右心劳损和移行血栓的急性肺栓塞，并指导进一步治疗。
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