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蒙多氏病:胸痛的罕见病因。

Mondor's Disease: A Rare Cause of Chest Pain.

作者信息

Bastos Mendes Jorge Miguel, Ferreira Gomes João Filipe, Rovisco Branquinho Lurdes, Oliveira Carvalho Catarina, Pacheco Mendes Patrícia Filipa Afonso Pais, Carvalho Madaleno João Luís

机构信息

Centro Hospitalar e Universitário de Coimbra, Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal.

USF Novo Norte, Arouca, Portugal.

出版信息

Eur J Case Rep Intern Med. 2020 Nov 23;7(12):001984. doi: 10.12890/2020_001984. eCollection 2020.

DOI:10.12890/2020_001984
PMID:33457356
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7806296/
Abstract

INTRODUCTION

Chest pain is a very frequent reason for seeking medical care. When there is no obvious cause, patients are sometimes subjected to tests and treatments that may be unnecessary and potentially harmful. Mondor's disease is a rare but usually benign and self-limited entity characterized by thrombophlebitis in a specific region.

CASE REPORT

We report the clinical case of a 51-year-old man admitted to the emergency department with a 24-hour history of left chest pain with no other symptoms. Physical examination revealed a palpable subcutaneous cord-like structure that ultrasound confirmed to be thrombophlebitis of a superficial vein in the mammary region. Secondary causes were ruled out, and the condition resolved with ibuprofen and the application of local ice.

DISCUSSION

Mondor's disease can be associated with neoplasms, trauma or hyperviscosity states, but it is mostly idiopathic. Usually, it resolves completely in 4-8 weeks without specific treatment. Because this infrequent diagnosis mainly relies on clinical findings, it is important that clinicians can recognize the syndrome.

LEARNING POINTS

Mondor's disease is a rare but benign disease, with no proof that specific treatment, such as anticoagulation, is beneficial.It may be secondary to underlying disease as malignancy, vasculitis, trauma or hyperviscosity states, which should be excluded.Treatment in the majority of the cases is symptomatic, but if it is secondary Mondor's disease, the underlying problem should be investigated. Physicians should be aware of this condition in order to address patient concerns and avoid unnecessary treatments or investigations.

摘要

引言

胸痛是寻求医疗护理的常见原因。当没有明显病因时,患者有时会接受可能不必要且有潜在危害的检查和治疗。蒙多氏病是一种罕见但通常为良性且自限性的疾病,其特征为特定区域的血栓性静脉炎。

病例报告

我们报告了一名51岁男性的临床病例,该患者因左胸痛24小时就诊于急诊科,无其他症状。体格检查发现可触及皮下条索状结构,超声证实为乳腺区域浅静脉血栓性静脉炎。排除了继发原因,使用布洛芬及局部冰敷后病情缓解。

讨论

蒙多氏病可能与肿瘤、创伤或高黏滞血症有关,但大多为特发性。通常,无需特殊治疗,4 - 8周可完全缓解。由于这种罕见诊断主要依赖临床表现,临床医生能够识别该综合征很重要。

学习要点

蒙多氏病是一种罕见但良性的疾病,尚无证据表明抗凝等特殊治疗有益。它可能继发于潜在疾病,如恶性肿瘤、血管炎、创伤或高黏滞血症,应予以排除。大多数情况下治疗为对症治疗,但若是继发性蒙多氏病,应调查潜在问题。医生应了解这种情况,以解决患者的担忧并避免不必要的治疗或检查。

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Mondor's Disease.蒙多氏病
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Mondor's Disease: A Review of the Literature.蒙多氏病:文献综述
Intern Med. 2018 Sep 15;57(18):2607-2612. doi: 10.2169/internalmedicine.0495-17. Epub 2018 May 18.
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Mondor's disease - a rare cause of chest pain: a case report.蒙多氏病——胸痛的罕见病因:一例报告
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