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Woman with epigastric pain and dyspnoea
Emergency Medicine Journal ( IF 3.1 ) Pub Date : 2022-09-01 , DOI: 10.1136/emermed-2021-211520
Ryohei Ono 1 , Sho Okada 2 , Yoshio Kobayashi 2
Affiliation  

An 85-year-old woman with no known coronary risk factors presented to the ED with a 5-day history of epigastric pain and sudden onset of dyspnoea. Her vital signs on arrival were unstable. Her BP was 68/38 mm Hg, and heart rate was 120 beats per minute. Physical examination revealed a harsh holosystolic murmur at the left sternal border and no peripheral oedema. The ECG (figure 1) and transthoracic echocardiography (figure 2, online supplemental video 1) were performed. ### Supplementary video [emermed-2021-211520supp001.mp4] Figure 1 Initial ECG. Figure 2 Transthoracic echocardiography. LA, left atrium; LV, left ventricle; RV, right ventricle). What is the likely diagnosis? 1. Left ventricular free-wall rupture. 2. Ventricular septal rupture. 3. Papillary muscle rupture. 4. Pseudoaneurysm. Answer: B. Ventricular septal rupture (VSR) …

中文翻译:

患有上腹痛和呼吸困难的妇女

一名 85 岁女性,没有已知的冠状动脉危险因素,因 5 天的上腹痛和突然发作的呼吸困难到急诊科就诊。她抵达时的生命体征不稳定。她的血压为 68/38 毫米汞柱,心率为每分钟 120 次。体格检查发现胸骨左缘有强烈的全收缩期杂音,无外周水肿。进行了心电图(图 1)和经胸超声心动图(图 2,在线补充视频 1)。### 补充视频 [emermed-2021-211520supp001.mp4] 图 1 初始心电图。图 2 经胸超声心动图。LA,左心房;LV,左心室;RV,右心室)。可能的诊断是什么?1.左心室游离壁破裂。2. 室间隔破裂。3. 乳头肌破裂。4. 假性动脉瘤。答案:B. 室间隔破裂 (VSR) …
更新日期:2022-08-23
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