■术后心脏并发症需要快速评估,这可能会受到各种挑战的阻碍。心脏手术后突然的呼吸急促并持续的血液动力学衰竭通常与肺栓塞或心脏压塞的治疗相矛盾有关。抗凝治疗是肺栓塞的首选治疗方法;然而,它可能会使心包积液恶化,因为控制出血和清除血块是治疗的主要手段。在这项研究中,我们介绍了一例由于模拟肺栓塞的心脏压塞引起的晚期心脏并发症。
■一名45岁男性,患有主动脉夹层DeBakeyII型,Bentall手术后7天,尽管接受了治疗,但仍出现突然的呼吸急促和持续的休克。X射线和经胸超声心动图评估的标志性成像体征支持针对肺栓塞的初始评估。然而,计算机断层扫描扫描结果提示心脏压塞主要积聚在心脏右侧,经经食道超声心动图证实,压迫肺动脉和腔静脉,从而模仿肺栓塞的发现。凝块排空程序后,患者在临床上有所改善,并于下周出院。
■在这项研究中,我们重点介绍了一例主动脉置换手术后出现典型肺栓塞的心脏填塞病例.医师应仔细分析患者的临床病史,物理,并支持检查以相应地指导和改变治疗过程,因为这两种并发症有相反的治疗原则,并可能加剧患者的病情。
UNASSIGNED: Post-operative cardiac complications require rapid evaluation, which may be hindered by various challenges. Sudden shortness of breath with persisting haemodynamic failure after cardiac procedure is often associated with cases of pulmonary embolism or cardiac tamponade that have contradicting therapies. Anticoagulant therapy is the treatment of choice for pulmonary embolism; however, it could worsen pericardial effusion where bleeding control and clot evacuation are the mainstays of treatment. In this study, we present a
case of late cardiac complication due to cardiac tamponade mimicking signs of pulmonary embolism.
UNASSIGNED: A 45-year-old male with aortic dissection DeBakey type-II, 7 day post-Bentall procedure, presented with sudden shortness of breath and persistent shock despite therapy. Initial assessment directed towards pulmonary embolism was supported by hallmark imaging signs from X-ray and transthoracic echocardiography evaluation. However, computed tomography scan results were suggestive of cardiac tamponade mainly accumulating at the right side of the heart, compressing the pulmonary artery and vena cava confirmed by transoesophageal echocardiography, thus mimicking the findings of pulmonary embolism. After clot evacuation procedure, the patient improved clinically and was discharged the following week.
UNASSIGNED: In this study, we highlight a
case of cardiac tamponade with classical findings of pulmonary embolism after an aortic replacement procedure. Physicians should carefully analyse a patient\'s clinical history, physical, and supporting examinations to direct and change the course of therapy accordingly, as these two complications have opposite therapy principles and may exacerbate the patient\'s condition.