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急性上腹部疼痛揭示双心室心肌梗死:一例报告

Acute epigastric pain unveiling biventricular myocardial infarction: A case report.

作者信息

Diallo Thierno Hamidou, Djafarou Boubacar Raynatou, Nana Yeboah Frederick, Ekhya Amoumoune Fatima, Mohamed Aden Fatouma, Bendagha Nesma, Fellat Rokya

机构信息

Department of Cardiology A, Ibn Sina University Hospital Center, Rabat, Morocco.

出版信息

SAGE Open Med Case Rep. 2024 Aug 31;12:2050313X241275366. doi: 10.1177/2050313X241275366. eCollection 2024.

Abstract

Acute coronary syndromes are a clinical entity frequently encountered in practice and are responsible for significant morbidity and mortality, despite therapeutic advances. The initiation of early reperfusion therapy reduces mortality and morbidity and improves patients' prognosis, but this depends on how quickly patients receive their treatment. Although it is often easy to diagnose in the presence of typical symptoms, certain patients, such as diabetics, sometimes have atypical symptoms, resulting in a delay in management. In nearly 50% of cases, inferior wall ischaemia is accompanied by right ventricular myocardial infarction; the clinical outcomes range from no hemodynamic compromise to severe hypotension and cardiogenic shock. In this article, we present the case of a 54-year-old male patient with active smoking and poorly controlled type 2 diabetes as cardiovascular risk factors who initially consulted at the first hour for epigastric pain, for which he received symptomatic treatment. As the symptoms persisted, he was admitted to our department at the eighth hour, where he was diagnosed with a biventricular infarction.

摘要

急性冠状动脉综合征是临床上常见的病症,尽管治疗取得了进展,但仍导致显著的发病率和死亡率。早期再灌注治疗的启动可降低死亡率和发病率,并改善患者的预后,但这取决于患者接受治疗的速度有多快。虽然在出现典型症状时通常很容易诊断,但某些患者,如糖尿病患者,有时会出现非典型症状,导致治疗延迟。在近50%的病例中,下壁缺血伴有右心室心肌梗死;临床结果从无血流动力学损害到严重低血压和心源性休克不等。在本文中,我们介绍了一名54岁男性患者的病例,该患者有主动吸烟和控制不佳的2型糖尿病等心血管危险因素,最初因上腹部疼痛在第1小时前来就诊,并接受了对症治疗。由于症状持续存在,他在第8小时被收入我院,在我院被诊断为双心室梗死。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5191/11367598/8e70b859af2b/10.1177_2050313X241275366-fig1.jpg

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