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肺栓塞:隐匿于心房扑动/心房 tachycardia 的伪装之下。 (注:tachycardia 常见释义为“心动过速”,此处结合语境翻译为“心房心动过速”更合适,但原文未完整给出该词准确意思,暂按字面翻译)

Pulmonary Embolism: Hidden in the Disguise of Atrial Flutter/Atrial Tachycardia.

作者信息

Saha Utsow, Arko Soumyadipto B, Shama Saiyara Sheikh, Gonzalez Carlos

机构信息

Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA.

Internal Medicine, Dhaka Medical College Hospital, Dhaka, BGD.

出版信息

Cureus. 2024 Sep 25;16(9):e70183. doi: 10.7759/cureus.70183. eCollection 2024 Sep.

Abstract

Every year, pulmonary embolism (PE) causes about 100,000 fatalities in the United States. Acute PE is a prevalent and occasionally fatal kind of venous thromboembolism (VTE). PE can appear in a variety of ways and is frequently nonspecific in its clinical presentation, making its diagnosis challenging. In order to limit the associated morbidity and mortality, individuals with suspected PE should be evaluated efficiently. This will allow for a prompt diagnosis and administration of medication. An efficient and convenient method for diagnosing PE is to use an electrocardiogram (EKG). Remembering that the typical EKG for PE cannot always be present is essential. Sinus tachycardia, a fairly nonspecific EKG presentation, is the most common. In this case report, we present a 60-year-old male who exhibited signs and symptoms of chest pain and dyspnea, with EKG showing atrial flutter, and was ultimately diagnosed with PE as the underlying trigger. The objective of this case study presentation was to highlight the need to rule out PE in patients exhibiting dyspnea and chest pain, even in the absence of a traditional textbook EKG appearance. It is very crucial to consider the holistic presentation of the patient. Acute onset dyspnea and chest pain should always prompt PE as an important differential.

摘要

在美国,每年肺栓塞(PE)导致约10万例死亡。急性肺栓塞是一种常见且偶尔致命的静脉血栓栓塞症(VTE)。肺栓塞可以有多种表现形式,其临床表现往往不具有特异性,这使得其诊断具有挑战性。为了降低相关的发病率和死亡率,应对疑似肺栓塞的患者进行有效评估。这将有助于及时诊断并给予药物治疗。一种有效且便捷的肺栓塞诊断方法是使用心电图(EKG)。必须记住,肺栓塞典型的心电图表现并非总是存在。窦性心动过速是最常见的,这是一种相当不具特异性的心电图表现。在本病例报告中,我们介绍了一名60岁男性,他出现胸痛和呼吸困难的症状和体征,心电图显示心房扑动,最终被诊断为肺栓塞是根本诱因。本病例研究报告的目的是强调,即使患者没有典型的教科书式心电图表现,对于出现呼吸困难和胸痛的患者,也需要排除肺栓塞。考虑患者的整体表现非常关键。急性发作的呼吸困难和胸痛应始终促使将肺栓塞作为重要的鉴别诊断。

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