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一名年轻患者罕见的栓子来源：病例报告与文献综述

Rare Source of Embolism in a Young Patient: Case Report and Literature Review.

作者信息

Vachalcová Marianna, Jankajová Monika, Jakubová Marta, Sieradzka Karolina Angela, Porubän Tibor, Valočik Gabriel, Šafár Peter, Ondušová Daniela, Petruš Ján, Schusterová Ingrid

机构信息

1st Department of Cardiology, East-Slovak Institute of Cardiovascular Diseases, 04011 Kosice, Slovakia.

Department of Functional Diagnostic, East-Slovak Institute of Cardiovascular Diseases, 04011 Kosice, Slovakia.

出版信息

J Clin Med. 2022 Apr 5;11(7):2038. doi: 10.3390/jcm11072038.

DOI:10.3390/jcm11072038
PMID:35407645
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8999600/
Abstract

We present a case of a 31-year-old patient, smoker, with no previous medical history, presenting with acute limb ischemia and infarction of the spleen due to peripheral embolism. The source of embolism was thrombi formations in the left ventricular cavity, located in the area of the regional wall motions abnormalities. CT and coronary angiography confirmed the total occlusion of the left anterior descending artery with collateralization. The patient underwent acute bilateral embolectomy of the iliac, femoral, and popliteal arteries. Subsequently, cardiothoracic surgery was indicated with coronary bypass surgery and extirpation of left ventricular masses, later confirmed as thrombus by pathology characteristics. Hematological examinations proved homozygous thrombophilia, and the patient was indicated for lifelong anticoagulation therapy.

摘要

我们报告一例31岁患者，有吸烟史，既往无病史，因外周栓塞出现急性肢体缺血和脾梗死。栓塞源为左心室腔内血栓形成，位于室壁运动异常区域。CT和冠状动脉造影证实左前降支完全闭塞并伴有侧支循环形成。患者接受了双侧髂动脉、股动脉和腘动脉急性取栓术。随后，建议进行心胸外科手术，包括冠状动脉搭桥手术和左心室肿物切除，术后病理特征证实为血栓。血液学检查证明为纯合子血栓形成倾向，该患者需接受终身抗凝治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cab/8999600/67528a45354f/jcm-11-02038-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cab/8999600/83bd65d74779/jcm-11-02038-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cab/8999600/61c35ab0202a/jcm-11-02038-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cab/8999600/db4d887b837f/jcm-11-02038-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cab/8999600/2e1219d658ae/jcm-11-02038-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cab/8999600/67528a45354f/jcm-11-02038-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cab/8999600/83bd65d74779/jcm-11-02038-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cab/8999600/61c35ab0202a/jcm-11-02038-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cab/8999600/db4d887b837f/jcm-11-02038-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cab/8999600/2e1219d658ae/jcm-11-02038-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cab/8999600/67528a45354f/jcm-11-02038-g005.jpg

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本文引用的文献

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Concomitant acute myocardial infarction and acute pulmonary embolism caused by paradoxical embolism: a case report.由反常栓塞引起的同时急性心肌梗死和急性肺栓塞：一例报告。
BMC Cardiovasc Disord. 2021 Jun 24;21(1):313. doi: 10.1186/s12872-021-02123-1.
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Acute Myocardial Infarction in Young Individuals.急性心肌梗死在年轻人中。
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