Schoenberg Benjamen, Alkhattabi Marwan, Lahham Shadi
University of California, Riverside, Riverside Community Hospital, Department of Emergency Medicine, Riverside, California.
University of California, Irvine, Department of Emergency Medicine, Orange, California.
Clin Pract Cases Emerg Med. 2020 Nov;4(4):628-629. doi: 10.5811/cpcem.2020.7.48117.
A 77-year-old female presented to the emergency department (ED) with chest pain. Cardiac point-of-care ultrasound (POCUS) was performed and demonstrated a hyperechoic structure on the posterior leaflet of the mitral valve. Admission to cardiology and echocardiogram revealed moderately decreased mobility of the posterior leaflet, mitral annular calcification, and severe mitral regurgitation.
These findings highlight the role of POCUS in identifying mitral valve pathology in the ED, ultimately leading to appropriate disposition and management. Mitral annular calcification can lead to significant manifestations including mitral stenosis or regurgitation, and advanced cases have been associated with an increased risk of infective endocarditis, thrombosis, and arrhythmia.
一名77岁女性因胸痛就诊于急诊科。进行了心脏床旁超声检查(POCUS),结果显示二尖瓣后叶上有一个高回声结构。入住心内科并进行超声心动图检查发现后叶活动度中度降低、二尖瓣环钙化以及重度二尖瓣反流。
这些发现凸显了床旁超声检查在急诊科识别二尖瓣病变中的作用,最终促成了恰当的处置和管理。二尖瓣环钙化可导致包括二尖瓣狭窄或反流在内的显著表现,病情严重时还与感染性心内膜炎、血栓形成及心律失常风险增加相关。