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在一名被误诊为哮喘的患者中使用床旁超声（POCUS）进行即时心力衰竭诊断

Instant Heart Failure Diagnosis Using Point-of-Care Ultrasound (POCUS) in a Patient Incorrectly Diagnosed With Asthma.

作者信息

Istrail Larry

机构信息

Hospital Medicine, Inova Fairfax Hospital, Falls Church, USA.

出版信息

Cureus. 2022 Jul 29;14(7):e27456. doi: 10.7759/cureus.27456. eCollection 2022 Jul.

DOI:10.7759/cureus.27456
PMID:36060372
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9420528/
Abstract

Congestive heart failure is one of the most common causes of hospitalization in the United States, yet it often goes undetected due to the poor sensitivity of chest X-rays for detecting pulmonary edema. In this case, a patient presented with one year of shortness of breath and a diagnosis of asthma; however, a three-minute point-of-care ultrasound (POCUS) exam revealed that the correct diagnosis was in fact congestive heart failure. This highlights the importance of incorporating POCUS into the physical exam of any patient presenting with cardiopulmonary symptoms.

摘要

充血性心力衰竭是美国住院治疗最常见的病因之一，但由于胸部X光检查检测肺水肿的敏感性较差，该病往往未被发现。在这个病例中，一名患者出现气短症状已有一年，最初被诊断为哮喘；然而，三分钟的即时超声检查（POCUS）显示，正确的诊断实际上是充血性心力衰竭。这凸显了将即时超声检查纳入任何有心肺症状患者体格检查的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ccb/9420528/b4d4a7514252/cureus-0014-00000027456-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ccb/9420528/b4d4a7514252/cureus-0014-00000027456-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ccb/9420528/b4d4a7514252/cureus-0014-00000027456-i01.jpg

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本文引用的文献

1
A Novel Method for Estimating Right Atrial Pressure With Point-of-Care Ultrasound.一种利用床旁超声估计右心房压力的新方法。
J Am Soc Echocardiogr. 2023 Mar;36(3):278-283. doi: 10.1016/j.echo.2022.12.008. Epub 2022 Dec 13.
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Disparity in the Setting of Incident Heart Failure Diagnosis.事件性心力衰竭诊断设置中的差异。
Circ Heart Fail. 2021 Aug;14(8):e008538. doi: 10.1161/CIRCHEARTFAILURE.121.008538. Epub 2021 Jul 27.
3
Diagnostic Accuracy of Lung Point-Of-Care Ultrasonography for Acute Heart Failure Compared With Chest X-Ray Study Among Dyspneic Older Patients in the Emergency Department.
肺部即时超声检查在急诊科呼吸困难老年患者中对急性心力衰竭的诊断准确性与胸部 X 线研究比较。
J Emerg Med. 2021 Aug;61(2):161-168. doi: 10.1016/j.jemermed.2021.02.019. Epub 2021 Mar 29.
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Med Ultrason. 2018 Feb 4;1(1):32-36. doi: 10.11152/mu-1223.
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Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis.即时床旁超声在以急性呼吸困难就诊的急性心源性肺水肿患者中的诊断价值：系统评价和 meta 分析。
Acad Emerg Med. 2014 Aug;21(8):843-52. doi: 10.1111/acem.12435.
8
Diagnostic accuracy and reproducibility of pleural and lung ultrasound in discriminating cardiogenic causes of acute dyspnea in the emergency department.胸膜和肺部超声在急诊科鉴别心源性急性呼吸困难病因中的诊断准确性和可重复性。
Intern Emerg Med. 2012 Feb;7(1):65-70. doi: 10.1007/s11739-011-0709-1. Epub 2011 Oct 28.
9
Combination of lung ultrasound (a comet-tail sign) and N-terminal pro-brain natriuretic peptide in differentiating acute heart failure from chronic obstructive pulmonary disease and asthma as cause of acute dyspnea in prehospital emergency setting.在院前急救环境中，肺超声（彗尾征）与 N 末端脑利钠肽前体联合应用，有助于鉴别急性心源性呼吸困难与慢性阻塞性肺疾病和哮喘。
Crit Care. 2011;15(2):R114. doi: 10.1186/cc10140. Epub 2011 Apr 14.
10
Application of color Doppler ultrasound in the study of small pleural effusion.彩色多普勒超声在小量胸腔积液研究中的应用
Med Ultrason. 2010 Mar;12(1):12-6.