Berrin Lily Leitner, Howell Kaitlen, Foote Amanda, Mullings Jordan, Desai Akash, Montgomery Martha, Barbant Sophie, Nagdev Arun
Highland Hospital, Alameda Health System, Department of Emergency Medicine, Oakland, California.
University of California San Francisco, Department of Emergency Medicine, San Francisco, California.
Clin Pract Cases Emerg Med. 2023 Aug;7(3):193-196. doi: 10.5811/cpcem.1590.
Coronary sinus thrombosis (CST) is a rare condition, primarily occurring after instrumentation of the heart, with no prior reported cases diagnosed via point-of-care ultrasound or of spontaneous occurrence without predisposing medical or surgical history. Patients typically present with critical illness, and CST has a reported mortality of 80%.
We present a case of a healthy 38-year-old male with chest pain one hour after cocaine use, with an electrocardiogram pattern consistent with Wellens syndrome, whose point-of-care cardiac ultrasound revealed CST.
This uncommon ultrasonographic finding has never been reported in the emergency medicine literature to our knowledge. It can be recognized by the clinician sonographer during standard point-of-care transthoracic echocardiogram.
冠状窦血栓形成（CST）是一种罕见病症，主要发生于心脏器械操作之后，此前尚无通过即时超声诊断的病例报告，也没有无诱发病史而自发发生的病例报告。患者通常表现为危重病，据报道CST的死亡率为80%。
我们报告一例38岁健康男性病例，该患者在使用可卡因一小时后出现胸痛，心电图表现符合Wellens综合征，其即时心脏超声检查显示存在CST。
据我们所知，这种罕见的超声检查结果在急诊医学文献中从未有过报道。临床超声医师在标准的即时经胸超声心动图检查过程中即可识别该病症。
