Ta'eed Anis, Wong Ai-Ming, Mulder John, Yang Yang
Department of Intensive Care Western Health Furlong Road St Albans Victoria 3021 Australia.
Department of Respiratory and Sleep Disorders Medicine Western Health Furlong Road St Albans Victoria 3021 Australia.
Australas J Ultrasound Med. 2020 Jan 2;23(2):140-143. doi: 10.1002/ajum.12193. eCollection 2020 May.
We present a rare case of a patient presenting with submassive pulmonary embolism (PE) further complicated by cardiac tamponade with the clinical dilemma on whether to perform thrombolysis or emergency pericardiocentesis to save her life. The aetiology of her pericardial effusion remains unclear but may possibly relate to post-PE pericarditis, a condition that resembles Dressler's syndrome. The pathophysiological processes of concurrent PE and cardiac tamponade combined to result in an unusual right ventricular shape on transthoracic echocardiography, and our findings raise the possibility of a fourth mechanism for the explanation of McConnell's sign - restricted free wall dilation via the moderator band.
我们报告了一例罕见病例，患者表现为亚大面积肺栓塞（PE），并进一步并发心脏压塞，临床上面临着是进行溶栓治疗还是紧急心包穿刺以挽救其生命的两难困境。其心包积液的病因尚不清楚，但可能与PE后心包炎有关，这种情况类似于德雷斯勒综合征。同时存在的PE和心脏压塞的病理生理过程共同导致经胸超声心动图上出现不寻常的右心室形态，我们的发现提出了麦康奈尔征的第四种解释机制的可能性——通过节制索限制游离壁扩张。
