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Aortic dissection

机译:主动脉夹层

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摘要

A 54-year-old woman presented to the emergency department with an 8h history of propagating "ripping" chest pain. She had hypertension which was controlled by a calcium channel blocker. On - arrival, she was agitated and hypotensive (92/62 mmHg). On examinations she had a grade 3/6 diastolic heart murmur along left sternal border and pulsus paradoxus. A 12-lead electrocardiogram showed sinus tachycardia and non-specific ST changes. Chest radiography showed a 13.9 mm distance between the intimal calcification and the outer aortic border due to displaced intimal calcification (Fig. 1, arrows). Multidetector-row computed tomography (MDCT) clearly showed a type A aortic dissection with intimal flap involving the entire aorta (asterisk) and hemopericardium (Fig. 2).
机译:一名54岁的妇女因传播“撕裂”性胸痛而在急诊科就诊已有8小时。她患有高血压,这是由钙通道阻滞剂控制的。到达后,她情绪激动且血压低(92/62 mmHg)。在检查中,她在左胸骨边界和脉搏异常之间有3/6级舒张期心脏杂音。 12导联心电图显示窦性心动过速和非特异性ST改变。胸部X线摄片显示,由于内膜钙化移位,内膜钙化与主动脉外缘之间有13.9 mm的距离(图1,箭头)。多排行计算机断层扫描(MDCT)清楚地显示了A型主动脉夹层,其内膜皮瓣累及整个主动脉(星号)和心包膜(图2)。

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