主動脈夾層病例報告英文

主動脈夾層病例報告英文版目前一頁\總數(shù)三十六頁\編于十六點Presenthistory:hospital1Consciousnessrecovered(onehourafteradmission)Paroxysmaldullpaininleftshoulderandlowerback.目前二頁\總數(shù)三十六頁\編于十六點Presenthistory：hospital1

NeurologicalDisorders?Neurologicalexaminationwasnormal.Cerebralcomputedtomography:normalRadiography:hyperosteogeny

lumbarhyperosteogeny?Symptomsrelieved:dischargedOtherwiseNormal目前三頁\總數(shù)三十六頁\編于十六點Presenthistory：hospital2RenalFailure?Cheststiffness&breathlessLowerlimbedema&oliguriaCreatinine:800mmol/LHemodialysisRelieved目前四頁\總數(shù)三十六頁\編于十六點Presenthistory：hospital3Cardiomyopathy?Endocarditis？Recurredcheststiffness&breathlessECG:nodaltachycardiaUCG:enlargedheartandaorta,hydropericardium.？？？目前五頁\總數(shù)三十六頁\編于十六點Presenthistory：cometousOnJanuary24th,2012,thepatientcametoourhospital.目前六頁\總數(shù)三十六頁\編于十六點

previoushistorySmokinganddrinkingCeasedsmokingandabstainedfromalcoholDenieddrugabuseNotawareofanyhereditarydiseaseinhisfamily.目前七頁\總數(shù)三十六頁\編于十六點

history：summary

Acombinationofdifferentclinicalfindings“Electricshocklike”pain(once)Syncope(once)Cheststiffness&BreathlessRepeatedlowbackpainPittingedemaoflowerextremityMonism目前八頁\總數(shù)三十六頁\編于十六點Analysis：pluralismAlgia：neurologicalpain？Acutecoronarysyndrome？Syncope：TIA？CerebralInfarction？Oliguria&

edema：renalfailure?Cheststiffnessandpain：ACS?PE?Fractured&confused目前九頁\總數(shù)三十六頁\編于十六點Analysis：monism？目前十頁\總數(shù)三十六頁\編于十六點GeneralexaminationVitalSignsBP:Left,104/74mmHg;right,123/77mmHg.waterhammerpulse(+)HeartGrade(Ⅳ/6)sighingdiastolicmurmurataorticvalvearea,whichradiatestowardtheapex.目前十一頁\總數(shù)三十六頁\編于十六點GeneralexaminationAbdomenMild,non-focalabdominaltendernessLowerextremitydiminishedleftlowerextremitypulses.目前十二頁\總數(shù)三十六頁\編于十六點LABFINDINGSBloodroutineWBC4.74G/L;Hb129g/LBloodbiochemistryNa145mmol/L,Cl111mmol/L,K4.1mmol/L,Glu5mmol/L,Urea5.7mmol/L,Cr107μmol/L,UA482μmol/L;CK121IU/L,CK-MB12.4IU/L,LDH-L198IU/L;AMY33IU/L,LPS57IU/L,AFP4.8μg/L;ThyroidfunctionT3=1.44nmol/L，T4=102nmol/L，fT3=4.23pmol/L,TSH=3.75mIU/L.OtherwiseNormal目前十三頁\總數(shù)三十六頁\編于十六點LABFINDINGSCoagulationfunctionPT=18S,INR=1.5,

D-Dimer:2.4mg/L(2400μg/L,normal:<500μg/L)ESR:4mm/h.

目前十四頁\總數(shù)三十六頁\編于十六點Imagingfindings目前十五頁\總數(shù)三十六頁\編于十六點Imagingfindings目前十六頁\總數(shù)三十六頁\編于十六點Imagingfindings目前十七頁\總數(shù)三十六頁\編于十六點Imagingfindings目前十八頁\總數(shù)三十六頁\編于十六點ImagingfindingsCTangiographyofchestandabdomen

目前十九頁\總數(shù)三十六頁\編于十六點discussion目前二十頁\總數(shù)三十六頁\編于十六點Discussion：generalAcuteaorticdissection(AAD)Aorticdissectionmaypresentwithavarietyofclinicalmanifestations目前二十一頁\總數(shù)三十六頁\編于十六點Discussion：general75%×Misdiagnosesinclude:myocardialinfarctioncerebralinfarction目前二十二頁\總數(shù)三十六頁\編于十六點Discussion：symptoms&signsPainless:5%Syncope：8%AADshouldbeconsideredinthedifferentialdiagnosisofsyncope,evenintheabsenceofpain.目前二十三頁\總數(shù)三十六頁\編于十六點DISCUSSION：symptoms&signsAADmaymimicanacutecoronarysyndrome目前二十四頁\總數(shù)三十六頁\編于十六點DISCUSSION：symptoms&signs目前二十五頁\總數(shù)三十六頁\編于十六點DISCUSSION：IMAGINGUptonow,variousnon-invasiveandinvasivediagnosticstepsarerequiredtodiagnoseortorule-outAADincaseofclinicalsuspicion.目前二十六頁\總數(shù)三十六頁\編于十六點DISCUSSION：IMAGINGCTandMRIofpatientswithsuspectedAADSensitivityandspecificityofCT：reaching100%SensitivityofMRIisupto95-100%目前二十七頁\總數(shù)三十六頁\編于十六點DISCUSSION：imagingUltrasoniccardiograms(UCG)TAS(ultrasoundoftheabdomen)TEE(transesophagealechocardiography)目前二十八頁\總數(shù)三十六頁\編于十六點DISCUSSION：labDeterminationofD-dimerD-Dimer:2.4mg/L(2400μg/L,normal:<500μg/L)目前二十九頁\總數(shù)三十六頁\編于十六點Discussion：TreatmentMedicationMAP60to75mmHgtargetHR：around60bpmBetablockersandnitroprussidesodiumCalciumchannelblockers目前三十頁\總數(shù)三十六頁\編于十六點Discussion：TREATMENTInterventionaltherapeuticmeasuresCardiothoracicSurgery目前三十一頁\總數(shù)三十六頁\編于十六點DISCUSSION：CLASSIFICATIONS目前三十二頁\總數(shù)三十六頁\編于十六點Discussion：PrognosisThelongtermfollow-upThemortalityrate：68%48hrs目前三十三頁\總數(shù)三十六頁\編于十六點Discussion：SummaryKeyinthemanagementofacuteaorticdissectionistoma