Earl-Royal Emily, Nguyen Phi D, Alvarez Al'ai, Gharahbaghian Laleh
Stanford School of Medicine, Department of Emergency Medicine, Palo Alto, California.
Kaiser Permanente Sacramento Medical Center, Department of Emergency Medicine, Sacramento, California.
Clin Pract Cases Emerg Med. 2019 Jul 8;3(3):202-207. doi: 10.5811/cpcem.2019.5.42928. eCollection 2019 Aug.
Aortic dissection (AD) is a rare, time-sensitive, and potentially fatal condition that can present with subtle signs requiring timely diagnosis and intervention. Although definitive diagnosis is most accurately made through computed tomography angiography, this can be a time-consuming study and the patient may be unstable, thus preventing the study's completion. Chest radiography (CXR) signs of AD are classically taught yet have poor diagnostic reliability. Point-of-care ultrasound (POCUS) is increasingly used by emergency physicians for the rapid diagnosis of emergent conditions, with multiple case reports illustrating the sonographic signs of AD. We present a case of Stanford type B AD diagnosed by POCUS in the emergency department in a patient with vague symptoms, normal CXR, and without aorta dilation. A subsequent review of CXR versus sonographic signs of AD is described.
主动脉夹层（AD）是一种罕见、对时间敏感且可能致命的疾病，其症状可能很隐匿，需要及时诊断和干预。虽然通过计算机断层扫描血管造影术能最准确地做出明确诊断，但这可能是一项耗时的检查，而且患者可能病情不稳定，从而无法完成该检查。AD的胸部X线摄影（CXR）征象虽常被传授，但诊断可靠性较差。床旁超声（POCUS）越来越多地被急诊医生用于快速诊断紧急情况，有多例病例报告阐述了AD的超声征象。我们报告一例在急诊科通过POCUS诊断为B型斯坦福AD的病例，该患者症状不明确，CXR正常，且无主动脉扩张。随后描述了对AD的CXR征象与超声征象的回顾。
