EMBOLIA PULMONARĂ ACUTĂ ASOCIATĂ CU INFARCTUL MIOCARDIC ACUT CU SUPRADENIVELARE DE SEGMENT ST
DOI:
https://doi.org/10.52692/1857-0011.2023.1-75.24Cuvinte cheie:
embolie pulmonară, infarct miocardicRezumat
Embolia pulmonară (EP) este o afecțiune potențial letală care se manifestă cu durere toracică sau dispnee pronunțată. Deși electrocardiograma (ECG) poate prezenta anomalii asociate EP, supradeniverarea de segment ST, caracteristică pentru infarctul miocardic acut anteroseptal (IMA), nu este caracteristică pentru pacienții cu EP acută. Această prezenta- re documentează cazul unui bărbat de 67 de ani care s-a prezentat la Unitatea primiri urgențe cu dispnee și durere retros- ternală. Datele ECG au sugerat un infarct miocardic anteroseptal și ischemie acută zona inferioară a ventriculului stâng. Cateterismul cardiac nu a depistat leziuni aterosclerotice ale arterelor coronare, dar a descoperit o anomalie de umplere embolică în artera coronară dreaptă. Examinarea ulterioară a pacientului a stabilit un embolism pulmonar bilateral masiv. Prin această prezentare accentuăm necesitatea investigării pacienților cu EP, care se prezintă cu durere toracică, dispnee sau ambele, chiar când modificările ECG sugerează o etiologie cardiacă. Prezentăm și o scurtă discuție despre eventualele mecanisme ale supradenivelării segmentului ST în embolismul pulmonar.
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