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一名年轻女性主动脉夹层的非典型表现及床旁超声在急诊科诊断主动脉夹层中的应用价值

Atypical Presentation of Aortic Dissection in a Young Female and the Utility of Point-of-Care Ultrasound in Identifying Aortic Dissection in the Emergency Department.

作者信息

Kaeley Nidhi, Gangdev Anand, Galagali Santosh S, Kabi Ankita, Shukla Krishna

机构信息

Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.

Anesthesiology, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND.

出版信息

Cureus. 2022 Jul 25;14(7):e27236. doi: 10.7759/cureus.27236. eCollection 2022 Jul.

DOI:10.7759/cureus.27236
PMID:36035033
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9399661/
Abstract

In the absence of prompt diagnosis and treatment, aortic dissection is an extremely dangerous and often fatal medical condition, of which acute coronary syndrome, stroke, limb ischemia, pulmonary embolism, and acute mesenteric ischemia are all possible manifestations. Neurological manifestations of aortic dissection are often missed at presentation. We report a case of a 23-year-old female without any prior characteristics of connective tissue disorder presenting to the emergency department with headache and right upper limb weakness and the utility of bedside point-of-care ultrasound (POCUS) for diagnosing aortic dissection.

摘要

在缺乏及时诊断和治疗的情况下,主动脉夹层是一种极其危险且通常致命的病症,急性冠状动脉综合征、中风、肢体缺血、肺栓塞和急性肠系膜缺血都是其可能的表现形式。主动脉夹层的神经学表现常在就诊时被漏诊。我们报告一例23岁女性病例,该患者无任何结缔组织病既往特征,因头痛和右上肢无力就诊于急诊科,以及床旁即时超声(POCUS)在诊断主动脉夹层中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a081/9399661/cdc3d25f9b0f/cureus-0014-00000027236-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a081/9399661/2a38e0db33a1/cureus-0014-00000027236-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a081/9399661/19adc92bdd17/cureus-0014-00000027236-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a081/9399661/f6804c31b89b/cureus-0014-00000027236-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a081/9399661/cdc3d25f9b0f/cureus-0014-00000027236-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a081/9399661/2a38e0db33a1/cureus-0014-00000027236-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a081/9399661/19adc92bdd17/cureus-0014-00000027236-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a081/9399661/f6804c31b89b/cureus-0014-00000027236-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a081/9399661/cdc3d25f9b0f/cureus-0014-00000027236-i04.jpg

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本文引用的文献

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Insights From the International Registry of Acute Aortic Dissection: A 20-Year Experience of Collaborative Clinical Research.国际急性主动脉夹层注册研究的启示:20 年的协作临床研究经验。
Circulation. 2018 Apr 24;137(17):1846-1860. doi: 10.1161/CIRCULATIONAHA.117.031264.
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Emergency physician focused cardiac ultrasound improves diagnosis of ascending aortic dissection.急诊医生聚焦心脏超声检查可改善升主动脉夹层的诊断。
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Diagnostic performance of emergency transthoracic focus cardiac ultrasound in suspected acute type A aortic dissection.
急诊经胸心脏聚焦超声对疑似急性A型主动脉夹层的诊断效能
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Correlates of delayed recognition and treatment of acute type A aortic dissection: the International Registry of Acute Aortic Dissection (IRAD).急性 A 型主动脉夹层延迟识别和治疗的相关因素:国际急性主动脉夹层注册研究(IRAD)。
Circulation. 2011 Nov 1;124(18):1911-8. doi: 10.1161/CIRCULATIONAHA.110.006320. Epub 2011 Oct 3.
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Epidemiology of thoracic aortic dissection.胸主动脉夹层的流行病学。
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Neurological symptoms in aortic dissection: a challenge for neurologists.主动脉夹层的神经系统症状:神经科医生面临的挑战。
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The diagnosis of aortic dissection by emergency medicine ultrasound.急诊医学超声对主动脉夹层的诊断
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Characterizing the young patient with aortic dissection: results from the International Registry of Aortic Dissection (IRAD).描述年轻主动脉夹层患者的特征:来自国际主动脉夹层注册研究(IRAD)的结果。
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The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease.国际急性主动脉夹层注册研究(IRAD):对一种古老疾病的新见解
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