《急診每日一題》心肌梗塞后急性二尖瓣返流2021年10月
Question?問(wèn)題:
Acute MR, a life-threatening complication of MI, is a cardiac emergency as it presents with sudden onset flash pulmonary edema, hypotension, and cardiogenic shock. Does the lack of murmur essentially exclude the diagnosis??Why??
急性二尖瓣返流(MR),急性心梗危機(jī)生命并發(fā)癥,是表現(xiàn)為突發(fā)性嚴(yán)重肺水腫,低血壓,和心源性休克的心臟急診。沒(méi)有雜音可以排除這個(gè)診斷嗎?為什么?
Answer?答案:
50% of patients with acute moderate to severe MR hAVe no audible murmur. Severe MR may be silent because reduced ventricular function minimizes the AV gradient, regurgitant flow, and subsequent murmur.?
50%中度到重度MR患者沒(méi)有可聽(tīng)到的雜音。由于降低的心室功能限制了房室壓差,返流流速,和既而產(chǎn)生的雜音,因此嚴(yán)重MR可以無(wú)雜音的。
參考文獻(xiàn):
Cureus. 2021;13:e13996
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