Sura Markos, Yegzeru Belete, Betre Bikamo, Demelash Ataro
{"title":"在资源有限的环境中应对疑似心脏淀粉样变性的诊断和管理挑战:埃塞俄比亚的经验","authors":"Sura Markos, Yegzeru Belete, Betre Bikamo, Demelash Ataro","doi":"10.1002/ccr3.9582","DOIUrl":null,"url":null,"abstract":"<p>This report discusses the diagnostic and therapeutic complexities encountered in resource-limited environments when assessing patients suspected of cardiac amyloidosis (CA). The study describes a case involving a patient who initially presented with heart failure symptoms and eventually received a CA diagnosis after 13 months and four primary physician visits, primarily based on discrepancies observed between electrocardiographic and echocardiographic findings, alongside elevated cardiac troponin levels. The case underscores the limited awareness of CA among primary healthcare providers in Ethiopia, contributing to a higher likelihood of misdiagnosis and inappropriate treatment approaches. Additionally, the report discusses the specific challenges associated with diagnosing and managing CA patients. It advocates for essential resources such as heightened clinical suspicion, proficiency in recognizing the characteristic electrocardiogram (ECG) and echocardiographic indicators of CA, and prompt referral to cardiologists.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"12 11","pages":""},"PeriodicalIF":0.6000,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.9582","citationCount":"0","resultStr":"{\"title\":\"Navigating the Diagnostic and Management Challenges of Suspected Cardiac Amyloidosis in Resource-Limited Settings: Ethiopia Experience\",\"authors\":\"Sura Markos, Yegzeru Belete, Betre Bikamo, Demelash Ataro\",\"doi\":\"10.1002/ccr3.9582\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>This report discusses the diagnostic and therapeutic complexities encountered in resource-limited environments when assessing patients suspected of cardiac amyloidosis (CA). The study describes a case involving a patient who initially presented with heart failure symptoms and eventually received a CA diagnosis after 13 months and four primary physician visits, primarily based on discrepancies observed between electrocardiographic and echocardiographic findings, alongside elevated cardiac troponin levels. The case underscores the limited awareness of CA among primary healthcare providers in Ethiopia, contributing to a higher likelihood of misdiagnosis and inappropriate treatment approaches. Additionally, the report discusses the specific challenges associated with diagnosing and managing CA patients. It advocates for essential resources such as heightened clinical suspicion, proficiency in recognizing the characteristic electrocardiogram (ECG) and echocardiographic indicators of CA, and prompt referral to cardiologists.</p>\",\"PeriodicalId\":10327,\"journal\":{\"name\":\"Clinical Case Reports\",\"volume\":\"12 11\",\"pages\":\"\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2024-11-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.9582\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ccr3.9582\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ccr3.9582","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
本报告讨论了在资源有限的环境中评估心脏淀粉样变性(CA)疑似患者时所遇到的诊断和治疗复杂性。研究描述了一个病例,该患者最初出现心力衰竭症状,经过 13 个月、4 次主治医生就诊后,最终确诊为心脏淀粉样变性,其主要依据是心电图和超声心动图结果之间的差异,以及心肌肌钙蛋白水平的升高。该病例强调了埃塞俄比亚初级医疗保健提供者对 CA 的认识有限,导致误诊和治疗方法不当的可能性增加。此外,报告还讨论了与诊断和管理 CA 患者相关的具体挑战。报告主张提供必要的资源,如加强临床怀疑、熟练识别 CA 的特征性心电图 (ECG) 和超声心动图指标,以及及时转诊给心脏病专家。
Navigating the Diagnostic and Management Challenges of Suspected Cardiac Amyloidosis in Resource-Limited Settings: Ethiopia Experience
This report discusses the diagnostic and therapeutic complexities encountered in resource-limited environments when assessing patients suspected of cardiac amyloidosis (CA). The study describes a case involving a patient who initially presented with heart failure symptoms and eventually received a CA diagnosis after 13 months and four primary physician visits, primarily based on discrepancies observed between electrocardiographic and echocardiographic findings, alongside elevated cardiac troponin levels. The case underscores the limited awareness of CA among primary healthcare providers in Ethiopia, contributing to a higher likelihood of misdiagnosis and inappropriate treatment approaches. Additionally, the report discusses the specific challenges associated with diagnosing and managing CA patients. It advocates for essential resources such as heightened clinical suspicion, proficiency in recognizing the characteristic electrocardiogram (ECG) and echocardiographic indicators of CA, and prompt referral to cardiologists.
期刊介绍:
Clinical Case Reports is different from other case report journals. Our aim is to directly improve global health and increase clinical understanding using case reports to convey important best practice information. We welcome case reports from all areas of Medicine, Nursing, Dentistry, and Veterinary Science and may include: -Any clinical case or procedure which illustrates an important best practice teaching message -Any clinical case or procedure which illustrates the appropriate use of an important clinical guideline or systematic review. As well as: -The management of novel or very uncommon diseases -A common disease presenting in an uncommon way -An uncommon disease masquerading as something more common -Cases which expand understanding of disease pathogenesis -Cases where the teaching point is based on an error -Cases which allow us to re-think established medical lore -Unreported adverse effects of interventions (drug, procedural, or other).