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植入式心脏复律除颤器植入术后肱静脉深静脉血栓形成:一位家庭医生的观点。

Deep Vein Thrombosis in the Humeral Vein After Implantable Cardioverter-Defibrillator Implantation: A Family Physician's Perspective.

作者信息

Alves Pedro, Silva João, Ribeiro João, Moreira Sónia

机构信息

Family Medicine, USF (Unidade de Saude Familiar) Tâmega, Administração Regional de Saúde do Norte, Porto, PRT.

Family Medicine, USF (Unidade de Saude Familiar) Alpendorada, Administração Regional de Saúde do Norte, Porto, PRT.

出版信息

Cureus. 2023 Dec 20;15(12):e50827. doi: 10.7759/cureus.50827. eCollection 2023 Dec.

Abstract

Upper extremity deep vein thrombosis (DVT) is an uncommon, under-reported, and difficult-to-diagnose condition. Although the strong provoking risk factors of venous thromboembolism are well described in the literature, the majority of cases are provoked by weak risk factors or are even considered unprovoked. In this case report, we describe a rare case of a brachial DVT in a woman in her 40s following implantable cardioverter-defibrillator (ICD) implantation. In her first evaluation, slight left arm edema and brachialgia were noted, and physiotherapy was prescribed. One month later, the patient was reevaluated because her complaints did not resolve, and an upper extremity venous ultrasound was done to exclude complications due to ICD implantation. The ultrasound identified an old DVT, which had been completely recanalized. The patient was then referred to a vascular surgery specialty consultation, which confirmed the diagnosis, and an anticoagulant was prescribed for three months. The symptoms resolved, and the patient did not report any more pain.

摘要

上肢深静脉血栓形成(DVT)是一种罕见、报告不足且难以诊断的疾病。尽管静脉血栓栓塞的强烈诱发危险因素在文献中已有详尽描述,但大多数病例是由微弱危险因素诱发的,甚至被认为是无诱因的。在本病例报告中,我们描述了一例罕见的40多岁女性在植入植入式心脏复律除颤器(ICD)后发生肱静脉DVT的病例。在首次评估时,发现左臂轻度水肿和臂痛,并给予了物理治疗。一个月后,由于患者的症状未缓解,对其进行了重新评估,并进行了上肢静脉超声检查以排除ICD植入引起的并发症。超声检查发现了一个已完全再通的陈旧性DVT。随后患者被转诊至血管外科专科会诊,会诊确认了诊断,并开具了为期三个月的抗凝药物。症状得到缓解,患者未再报告任何疼痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7316/10797848/bda7596ce01e/cureus-0015-00000050827-i01.jpg

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