吞咽困难作为老年人心脏代偿失调的早期迹象：病例报告
Dysphagia as an early sign of cardiac decompensation in elderly: case report.
作者信息
Matta Anthony, Elenizi Khaled, Carrié Didier, Roncalli Jerome
机构信息
Faculty of Medicine, Holy Spirit University of Kaslik, Kaslik, Lebanon.
Department of Cardiology, Institute CARDIOMET, Rangueil Hospital, Toulouse, France.
出版信息
Eur Heart J Case Rep. 2020 Jun 17;4(4):1-5. doi: 10.1093/ehjcr/ytaa149. eCollection 2020 Aug.
BACKGROUND
Several clinical entities may be misdiagnosed in elderly if we consider dysphagia as a normal aging process in our daily practice. On top of usual aetiologies like motor dysfunction, investigations may uncover serious underlying conditions.
CASE SUMMARY
We report an unusual case where dysphagia was the warning sign for acute heart failure in a 76-year-old patient known to have dilated cardiomyopathy with reduced ejection fraction. It was due to an external oesophageal compression by the left atrium. A transthoracic echocardiography, an enhanced thoracic computed tomography-scan and esophagogastroduodenoscopy were used for the diagnosis. Diuretics were the cornerstone treatment with symptomatic improvement.
DISCUSSION
Despite the fact that cardiovascular dysphagia is an uncommon medical entity, but it remains a potential differential diagnosis, especially in elderlies with high risk for atrial enlargement.
背景
在日常实践中，如果我们将吞咽困难视为正常的衰老过程，那么老年患者的几种临床病症可能会被误诊。除了运动功能障碍等常见病因外，检查可能会发现严重的潜在疾病。
病例摘要
我们报告了一例不寻常的病例，一名76岁已知患有射血分数降低的扩张型心肌病患者，吞咽困难是急性心力衰竭的警示信号。这是由于左心房对食管外部的压迫所致。经胸超声心动图、增强胸部计算机断层扫描和食管胃十二指肠镜检查用于诊断。利尿剂是基础治疗方法，症状有所改善。
讨论
尽管心血管性吞咽困难是一种不常见的医学病症，但它仍然是一种潜在的鉴别诊断，尤其是在有心房扩大高风险的老年人中。
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