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病例8-2018:一名休克和血压不稳定的55岁女性
Case 8-2018 — A 55-Year-Old Woman with Shock and Labile Blood Pressure


Joseph Loscalzo ... 肿瘤 • 2018.03.15

病例陈述


Nathalie Roy医师:一名55岁女性被转到本院,以评估和治疗心源性休克。

就诊前约4个月,患者因常规慢跑后出现持续40分钟的胸部“剧烈心跳感”、恶心和出汗被收入所在州医院。其心率为65次/分,血压为138/72 mmHg,其余检查结果正常。四次连续心电图结果正常,但肌钙蛋白Ⅰ水平升高,数值为0.055 ng/mL,且11小时后升高至0.415 ng/mL(正常范围,0~0.045 ng/mL)。经胸超声心动图显示双心室功能正常。冠状动脉造影显示无阻塞性冠状动脉疾病的证据;左心室舒张期末压为5 mmHg。出院(入院后4日)后,心脏磁共振成像(MRI)显示双心室功能和大小正常,没有心肌水肿或纤维化证据。为其开具了阿司匹林和一种β受体阻滞剂,用于治疗推测存在的运动相关室上性心动过速。





作者信息

Joseph Loscalzo, M.D., Ph.D., Nathalie Roy, M.D., Ravi V. Shah, M.D., Joy N. Tsai, M.D., Alexis M. Cahalane, M.D., Johannes Steiner, M.D., and James R. Stone, M.D., Ph.D.
From the Department of Medicine, Brigham and Women’s Hospital (J.L.), the Departments of Surgery (N.R.), Medicine (R.V.S., J.N.T., J.S.), Radiology (A.M.C.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Medicine (J.L., R.V.S., J.N.T., J.S.), Surgery (N.R.), Radiology (A.M.C.), and Pathology (J.R.S.), Harvard Medical School — all in Boston.

 

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