Edwards Timothy, Børsheim Elisabet, Tomlinson Andrew R
Arkansas Children's Nutrition Center, Little Rock, AR.
Arkansas Children's Research Institute, Little Rock, AR.
Mayo Clin Proc Innov Qual Outcomes. 2024 Nov 13;8(6):530-535. doi: 10.1016/j.mayocpiqo.2024.10.001. eCollection 2024 Dec.
A 20-year-old male underwent diagnostic testing due to unexplained shortness of breath and chest discomfort. He had no previous medical problems and was not taking any medications. Initial evaluations included cardiopulmonary exercise testing (CPET), which yielded results that were reported as normal. However, over the following 2 months, his symptoms worsened considerably, including dyspnea with climbing stairs and then hemoptysis. Seeking urgent medical care, he presented to the emergency department, where he underwent further testing and was admitted to the hospital. Computed tomography angiogram reported bilateral pulmonary emboli. His parents requested a second opinion regarding the analysis of the CPET data, which revealed previously overlooked abnormalities. This overlooked data delayed pulmonary embolism diagnosis, and the patient ultimately required bilateral pulmonary thromboendarterectomy. In this case, we describe the hallmark signs of pulmonary vascular disease seen during CPET and offer clinical pearls to aid in timely detection.
一名20岁男性因不明原因的呼吸急促和胸部不适接受了诊断测试。他既往无任何医疗问题，也未服用任何药物。初始评估包括心肺运动试验（CPET），结果报告为正常。然而，在接下来的2个月里，他的症状显著恶化，包括爬楼梯时呼吸困难，随后出现咯血。他寻求紧急医疗护理，前往急诊科就诊，在那里接受了进一步检查并被收治入院。计算机断层血管造影报告显示双侧肺栓塞。他的父母要求对CPET数据的分析进行二次诊断，结果发现了之前被忽视的异常情况。这些被忽视的数据延误了肺栓塞的诊断，患者最终需要接受双侧肺动脉血栓内膜剥脱术。在本病例中，我们描述了CPET期间所见肺血管疾病的标志性体征，并提供有助于及时检测的临床要点。
