Zelfani Saida, Manai Hela, Laabidi Saoussen, Wahabi Abir, Akeri Sara, Daghfous Mounir
Pre Hospital Emergency Department (SAMU 01), Emergency Medical Help Center of Tunis, Tunis, Tunisia.
Pan Afr Med J. 2019 Jul 30;33:275. doi: 10.11604/pamj.2019.33.275.18517. eCollection 2019.
The diagnosis of pulmonary thromboembolism (PTE) with changes shown by electrocardiography (ECG) is a challenge in the clinical practice due to rare pathognomonic findings. We report the case of a 37-year old woman managed in out of hospital sitting for a chest pain. Electrocardiogram was suggestive of antero-septal acute myocardial infarction (AMI). Catheterization revealed non occlusive coronary disease. Transthoracic echocardiography showed an elevated pulmonary and right heart pressures. Computed tomography pulmonary angiography confirmed the diagnosis of bilateral pulmonary embolism. PTE with ECG changes should be considered in the differential diagnosis of AMI, particularly in young patients with chest pain and ST segment elevation suggestive of acute coronary syndrome.
由于缺乏典型的诊断依据，通过心电图（ECG）表现来诊断肺血栓栓塞症（PTE）在临床实践中是一项挑战。我们报告一例37岁女性患者，因胸痛在院外就诊。心电图提示前间壁急性心肌梗死（AMI）。心导管检查显示非闭塞性冠状动脉疾病。经胸超声心动图显示肺和右心压力升高。计算机断层扫描肺动脉造影证实双侧肺栓塞的诊断。在AMI的鉴别诊断中，应考虑伴有心电图改变的PTE，尤其是在有胸痛且ST段抬高提示急性冠状动脉综合征的年轻患者中。
