Kahl Nicolas, Gabriel Christopher, Lahham Shadi, Thompson Maxwell, Hoonpongsimanont Wirachin
University of California, Irvine, Department of Emergency Medicine, Orange, California.
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。
