注意肺栓塞的非特异性表现：病例报告。

Be aware of non-specific presentation of pulmonary embolism: a case report.

机构信息

The First Clinical Medical College, Henan University of Traditional Chinese Medicine, Zhengzhou, 450000, Henan, China.

Department of Intervention, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, 450000, Henan, China.

出版信息

BMC Cardiovasc Disord. 2023 Feb 10;23(1):76. doi: 10.1186/s12872-023-03096-z.

DOI:10.1186/s12872-023-03096-z

PMID:36759780

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9912511/

Abstract

BACKGROUND

The early diagnosis of non-specific presentation of pulmonary embolism (PE) is difficult because the symptoms are non-specific and varied.

CASE PRESENTATION

A 69-year-old female patient had syncope accompanied by gait disturbance, without obvious inducement. The patient was initially suspected to have cerebral infarction, but the symptoms did not improve and myocardial markers increased after two days of symptomatic treatment for myocardial infarction. Hence, PE was suspected and computed tomography pulmonary angiography (CTPA) examination confirmed the diagnosis. CTPA showed multiple emboli in pulmonary artery and its branches, so high-risk PE was diagnosed. Intravenous thrombolysis was administered, and pulmonary CTA showed a significant reduction of emboli in pulmonary artery and its left and right branches.

CONCLUSION

This case report highlights the importance of improving the clinical awareness about non-specific presentation of PE and avoiding misdiagnosis or missed diagnosis.

摘要

背景

非特异性表现的肺栓塞（PE）早期诊断较为困难，因为其症状非特异性且多样化。

病例介绍

一位 69 岁女性患者出现晕厥伴步态不稳，无明显诱因。患者最初被怀疑为脑梗死，但两天的对症治疗后症状无改善，心肌标志物升高。故怀疑为 PE，行 CT 肺动脉造影（CTPA）检查后确诊。CTPA 显示肺动脉及其分支多发栓塞，故诊断为高危 PE。给予静脉溶栓治疗，肺 CTA 显示肺动脉及其左右分支的栓塞明显减少。