复苏性经食道超声心动图确定主动脉夹层肠套叠是aVR STEMI的原因

JEM reports Pub Date : 2023-06-01 DOI:10.1016/j.jemrpt.2023.100029

Andrew Loftus, Samer Abou-Arbid, David Marshall, Julian Suszanski, Christopher Clark

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引用次数: 0

摘要

急诊医师使用经食管超声心动图(TEE)作为一种有前途的工具来帮助复苏期间的诊断和治疗。病例报告我们报告了一例aVR st段抬高型心肌梗死，随后心脏骤停，并通过复苏TEE停搏诊断主动脉夹层。我们认为主动脉夹层通过主动脉瓣引起严重的主动脉反流、左心室流出道梗阻和冠状动脉内膜肠套叠灌注不良，最终导致死亡。急诊医生为什么要意识到这一点?复苏TEE迅速发现了这种意想不到的危及生命的病理，并彻底改变了患者的管理。

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Resuscitative transesophageal echocardiography identifies aortic dissection intussusception as the cause of aVR STEMI

Background

Emergency physician use of transesophageal echocardiography (TEE) is emerging as a promising tool to aid diagnosis and treatment during resuscitation.

Case report

We present a case of aVR ST-elevation myocardial infarction followed by witnessed cardiac arrest and diagnosis of aortic dissection by resuscitative TEE intra-arrest. We propose the aortic dissection caused severe aortic regurgitation, left ventricular outflow tract obstruction and coronary artery malperfusion due to intimal intussusception through the aortic valve, ultimately resulting in death.