Mu Guanyu, Li Feixue, Chen Xiaolin, Zhao Bo, Li Guangping, Fu Huaying
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology Second Hospital of Tianjin Medical University Tianjin China.
Clin Case Rep. 2022 Jul 19;10(7):e6105. doi: 10.1002/ccr3.6105. eCollection 2022 Jul.
Acute pulmonary embolism (APE) is a life-threatening disease with nonspecific clinical signs and symptoms. Rapid and accurate diagnosis is crucial for the clinical management of patients with acute pulmonary embolism. A recommended echocardiography view may be of further help in the diagnosis and evaluation of the change in thrombosis and treatment. We reported a case of a 74-year-old man with a 12-day history of decreased exercise capacity and dyspnea. The patient was diagnosed with intermediate-risk APE as several pulmonary emboli in pulmonary artery were seen in multidetector computed tomographic pulmonary angiography with normal blood pressure and echocardiographic right ventricular overload. And we found a pulmonary artery clot in the right pulmonary artery through transthoracic echocardiography. After 11-days anticoagulation, the patient underwent a reassessment, showed a decrease in RV diameter and pulmonary artery thrombus. This case highlights the significant role that echocardiography played in a patient who presented pulmonary embolism with a stable hemodynamic situation and normal blood pressure. The modified echocardiographic view could provide correct diagnosis by identifying the clot size and location visually. Knowledge of the echocardiography results of APE would aid the diagnosis.
急性肺栓塞(APE)是一种具有非特异性临床体征和症状的危及生命的疾病。快速准确的诊断对于急性肺栓塞患者的临床管理至关重要。推荐的超声心动图视图可能对血栓形成变化的诊断和评估以及治疗有进一步帮助。我们报告了一例74岁男性患者,有12天运动能力下降和呼吸困难病史。在多排螺旋CT肺动脉造影中可见肺动脉内有多个肺栓塞,血压正常且超声心动图显示右心室负荷过重,该患者被诊断为中度风险APE。并且我们通过经胸超声心动图在右肺动脉发现了一个肺动脉血栓。经过11天的抗凝治疗后,患者接受重新评估,显示右心室直径和肺动脉血栓减小。该病例突出了超声心动图在血流动力学稳定且血压正常的肺栓塞患者中所起的重要作用。改良的超声心动图视图可通过直观识别血栓大小和位置提供正确诊断。了解APE的超声心动图结果将有助于诊断。