Cleveland Manchanda Emily C, Kharasch Sigmund J, Liteplo Andrew S
Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts.
Clin Pract Cases Emerg Med. 2019 Jul 1;3(3):271-274. doi: 10.5811/cpcem.2018.9.39218. eCollection 2019 Aug.
A healthy 18-year-old male presented to the emergency department with chest pain, palpitations, and dyspnea. His exam was unremarkable; however, point-of-care ultrasound (POCUS) revealed right ventricular strain with a D-sign and enlarged right ventricle. He subsequently reported a history of factor V Leiden. His D-dimer was markedly elevated, and a computed tomography angiogram of the chest demonstrated submassive pulmonary embolism (PE). He was taken to the catheterization lab for directed thrombolysis and was discharged in good condition two days later. Factor V Leiden is the most common genetic cause of venous thromboembolism. POCUS can facilitate rapid diagnosis and risk stratification of patients with acute PE.
一名健康的18岁男性因胸痛、心悸和呼吸困难被送往急诊科。他的体格检查未见异常；然而，床旁超声（POCUS）显示右心室应变伴D征和右心室扩大。他随后报告有因子V莱顿病史。他的D-二聚体显著升高，胸部计算机断层血管造影显示亚大面积肺栓塞（PE）。他被送往导管室进行定向溶栓治疗，两天后病情良好出院。因子V莱顿是静脉血栓栓塞最常见的遗传原因。POCUS有助于对急性PE患者进行快速诊断和风险分层。
