Berkenwald A D
Department of Emergency Services, Baystate Medical Center, Springfield, MA.
Am J Emerg Med. 1993 Jan;11(1):67-9. doi: 10.1016/0735-6757(93)90064-i.
A case of brachial artery embolism presenting as ischemic coronary artery disease is presented. The patient presented with sudden onset of left arm pain, shortness of breath, nausea, vomiting, and diaphoresis. Initial relief with sublingual nitroglycerin was seen. With further evaluation, a brachial artery embolus was diagnosed, and an embolectomy was successfully performed. Delay in diagnosis and treatment can lead to substantial morbidity, including gangrene and amputation. Misdiagnosis is common, as it is seen in the same patients at risk for ischemic heart disease, stroke, and other vascular abnormalities. An awareness of this problem is important among those who initially evaluate patients in emergency departments.
本文介绍了一例表现为缺血性冠状动脉疾病的肱动脉栓塞病例。患者出现左臂突发疼痛、呼吸急促、恶心、呕吐和出汗症状。舌下含服硝酸甘油后症状初步缓解。经过进一步评估，诊断为肱动脉栓子，并成功进行了栓子切除术。诊断和治疗的延迟可能导致严重的发病率，包括坏疽和截肢。误诊很常见，因为在患有缺血性心脏病、中风和其他血管异常风险的同一患者中也会出现。对于在急诊科最初评估患者的人员来说，认识到这个问题很重要。
