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一例与新型冠状病毒肺炎相关的单纯性心包炎:经典临床评估在鉴别诊断中的应用

A Case of Pure Pericarditis Associated With COVID-19: Application of Classical Clinical Evaluation for Differential Diagnosis.

作者信息

Pettit George W, Eubank Leisa M, Richard Joshua, Brown Ethan T, Gopikishan Rangaraj R

机构信息

Emergency Department, ERKaty, Katy, USA.

Family Medicine, Right Choice Urgent Care, Cypress, USA.

出版信息

Cureus. 2023 Apr 18;15(4):e37794. doi: 10.7759/cureus.37794. eCollection 2023 Apr.

Abstract

Pericarditis of varying severity is being recognized as a rare complication of the COVID-19 infection. We present a patient with an electrocardiogram (EKG) and physical exam findings that initially seemed to most likely be pericarditis related to the COVID-19 infection. The differential diagnosis was a bit difficult because it included ST-segment elevation myocardial infarction (STEMI) due to some EKG changes and early repolarization changes that were rather robust. Treatment options for STEMI could cause severe harm if the process turned out to be pericarditis. Treatment options for pericarditis could cause severe harm if the process turned out to be STEMI. And treatment options for early repolarization might be no treatment at all, which could cause harm if the process turned out to be STEMI or pericarditis. In this case, a correct diagnosis was very important to ensure a good clinical outcome. We would like to share our thought processes in the management of this case.

摘要

不同严重程度的心包炎正被视为新型冠状病毒肺炎(COVID-19)感染的一种罕见并发症。我们介绍一位患者,其心电图(EKG)和体格检查结果最初似乎极有可能是与COVID-19感染相关的心包炎。鉴别诊断有点困难,因为其包括因一些EKG变化导致的ST段抬高型心肌梗死(STEMI)以及相当明显的早期复极变化。如果最终诊断为心包炎,STEMI的治疗方案可能会造成严重损害。如果最终诊断为STEMI,心包炎的治疗方案可能会造成严重损害。而早期复极的治疗方案可能根本无需治疗,如果最终诊断为STEMI或心包炎,这可能会造成损害。在这种情况下,正确诊断对于确保良好的临床结果非常重要。我们希望分享我们在该病例管理中的思维过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d0b/10113064/41533ea310f5/cureus-0015-00000037794-i01.jpg

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