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室间隔破裂与人工智能辅助医疗

Ventricular Septal Rupture and Artificial Intelligence (AI)-Assisted Healthcare.

作者信息

Lal Vallath Aditya, Sivasubramanian Barath Prashanth, Chatterjee Aryapriyo, Erva Snigdha, Ravikumar Diviya Bharathi, Dasgupta Indraneel

机构信息

Emergency Medicine, Peerless Hospital and B. K. Roy Research Centre, Kolkata, IND.

Internal Medicine, Employees State Insurance Corporation Medical College & Employees State Insurance Post Graduate Institute of Medical Sciences and Research (ESIC MC & PGIMSR), Chennai, IND.

出版信息

Cureus. 2023 Mar 23;15(3):e36581. doi: 10.7759/cureus.36581. eCollection 2023 Mar.

Abstract

This case report highlights the use of point-of-care ultrasound (POCUS) for the diagnosis of ventricular septal rupture (VSR), a severe consequence of acute myocardial infarction (AMI). VSR has a broad spectrum of signs and inconspicuous symptoms, making the diagnosis difficult. POCUS offers non-invasive, real-time cardiac imaging and has an advantage over other methods due to its ability to identify VSR early. Here we present a 63-year-old female with a history of type 2 diabetes, hypothyroidism, hyperlipidemia, and a family history of cardiovascular disease, who came to the ED with chest pain for three days, palpitations, and dyspnea at rest. On examination, the patient was hypotensive, tachycardic, and had crackles with a harsh holosystolic murmur. An EKG and elevated troponin levels suggested acute on chronic anterior-lateral wall ST-elevation myocardial infarction (STEMI). Resuscitation efforts were initiated, followed by a lung ultrasound that revealed good lung sliding and multiple B lines without pleural thickening, indicating pulmonary edema. Echocardiography revealed ischemic heart disease with moderate left ventricle (LV) systolic dysfunction and a 14 mm apical ventricular septal rupture (hypokinetic thinning of the anterior wall, septum, apex, and anterolateral wall with a left ventricular ejection fraction (LVEF) of 39%). The presence of flow on color Doppler across the interventricular septum, showing left-to-right shunting, led to a definitive diagnosis of acute-on-chronic myocardial infarction (MI) with ventricular septal rupture. The case report also emphasizes how modern AI applications like ChatGPT (OpenAI, San Francisco, California, United States), aid in language and research, saving time and redefining the healthcare and research industry. As a result, we are confident that AI-assisted healthcare will be the next global breakthrough.

摘要

本病例报告强调了床旁超声(POCUS)在诊断室间隔破裂(VSR)中的应用,VSR是急性心肌梗死(AMI)的严重后果。VSR有广泛的体征且症状不明显,诊断困难。POCUS提供无创、实时心脏成像,因其能够早期识别VSR而比其他方法具有优势。我们在此介绍一位63岁女性,有2型糖尿病、甲状腺功能减退、高脂血症病史,且有心血管疾病家族史,因胸痛三天、心悸和静息时呼吸困难前来急诊科就诊。检查时,患者血压低、心动过速,有啰音及粗糙的全收缩期杂音。心电图和肌钙蛋白水平升高提示慢性前侧壁ST段抬高型心肌梗死(STEMI)急性发作。启动了复苏措施,随后肺部超声显示肺滑动良好且有多个B线,无胸膜增厚,提示肺水肿。超声心动图显示缺血性心脏病,左心室(LV)中度收缩功能障碍,室间隔顶部有14毫米破裂(前壁、室间隔、心尖和前侧壁运动减弱变薄,左心室射血分数(LVEF)为39%)。彩色多普勒显示室间隔有血流,呈左向右分流,从而明确诊断为慢性心肌梗死(MI)急性发作伴室间隔破裂。该病例报告还强调了像ChatGPT(美国加利福尼亚州旧金山OpenAI公司)这样的现代人工智能应用如何有助于语言和研究,节省时间并重新定义医疗保健和研究行业。因此,我们相信人工智能辅助医疗将成为下一个全球突破。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af4c/10122442/53db75598bf9/cureus-0015-00000036581-i01.jpg

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