Moreira-Marques Torcato, Tung-Chen Yale, Martinez-Piñero Ana
Department of Internal Medicine, Centro Hospitalar Universitário de Lisboa Central - Hospital de Santa Marta, Unidade Funcional de Medicina Interna, Lisbon, Portugal.
Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Calle Joaquín Rodrigo, Majadahonda, Madrid, Spain.
J Med Ultrasound. 2022 Mar 4;30(4):297-299. doi: 10.4103/jmu.jmu_116_21. eCollection 2022 Oct-Dec.
Point-of-care ultrasound (POCUS) has become a reliable and powerful tool working as a complement to the traditional physical examination. It has proven to be a reliable and reproducible method to a quicker and safer diagnosis, sometimes surpassing the diagnostic accuracy of more traditional techniques. We present two cases of pulmonary embolism (PE) with clinical presentations that suggested other diagnoses, prior to the performance of POCUS: a 60-year-old patient with nausea and vomiting and a 66-year-old female with a week-long progressive increase of shortness of breath and increased peripheral edema. In the reported cases, we aim to pinpoint the importance and usefulness of POCUS in the everyday evaluation of our patients, in multiple settings and by multiple specialty physicians, supported by its robust evidence-based background. It has proven to be a useful tool in evaluating in a fast and nonharmful way complementing more traditional techniques, which proves to be especially important regarding cases, like the ones we describe, when the correct diagnosis is not always clear to presentation. The use of multiorgan POCUS allows even in the most atypical presentations, the rise of suspicion of PE, leading to the necessary steps to a final diagnosis and management.
床旁超声（POCUS）已成为一种可靠且强大的工具，作为传统体格检查的补充。它已被证明是一种可靠且可重复的方法，能实现更快、更安全的诊断，有时甚至超越了更传统技术的诊断准确性。在进行床旁超声检查之前，我们介绍两例肺栓塞（PE）病例，其临床表现提示了其他诊断：一例是一名60岁伴有恶心和呕吐的患者，另一例是一名66岁女性，其气短症状持续一周进行性加重且外周水肿加重。在这些报告的病例中，我们旨在明确床旁超声在我们对患者的日常评估中的重要性和实用性，适用于多种情况且由多个专科医生使用，其有强有力的循证医学背景作为支撑。它已被证明是一种以快速且无害的方式进行评估的有用工具，可补充更传统的技术，这对于像我们所描述的病例尤为重要，因为在这些病例中，正确诊断在初诊时并不总是明确的。即使在最不典型的表现中，使用多器官床旁超声也能提高对肺栓塞的怀疑度，从而采取必要步骤进行最终诊断和治疗。
