Acute Aortic Dissection Presenting with Heart Failure without Chest Pain: A Case Report

一位30歲男性，過去有高血壓病史，並於診所按時服藥。本次於入院前兩週因持續的咳嗽合併呼吸急促及喘曾經於地區診所求診，告知有上呼吸道的症狀。但即使病患使用呼吸及抗生素藥物的治療，仍舊無效。因此病患尋求本院急診的醫療照護，於診斷及檢查的過程中，病人持續抱怨有嚴重呼吸急促及咳嗽的問題。並於隨後的心電圖檢查發現有V1-V6全導極的ST-T改變，因此安排心臟超音波檢查，並意外發現有主動脈瘤問題，並且於隨後的電腦斷層證實病人罹患Type A型的主動脈剝離。經由本個案提醒我們，遇到一個年輕男性，過去無任何特殊的病史，若是以突發性的心衰竭表現的個案，除了常見的發炎，免疫系統疾病外，也要小心是否有致命的主動脈剝離的問題。

關鍵字

急性主動脈剝離；無胸痛；急性心衰竭；胜肽BNP

並列摘要

Acute aortic dissection (AD) is a life-threatening medical condition. The signs and symptoms of AD usually include chest, back, neck or jaw pain, syncope, hemiparesis, and dyspnea. Although some patients with aortic dissection do not present with chest or back pain, painless aortic dissection is relatively uncommon. A 30-year-old man with a history of hypertension and irregular medical treatment presented with cough and dyspnea without chest pain at a local clinic. Because of deterioration from the illness, he came to our hospital for further evaluation two weeks later and an unanticipated aortic dissection was found. This case reminds us that if a young man without any history of congenital or immune systemic disease presents with sudden onset heart failure, fatal aortic stripping problems must be carefully considered in addition to common inflammatory and immune system diseases.

並列關鍵字

painless aortic dissection ； heart failure ； NT-proBNP

國際替代計量

Acute Aortic Dissection Presenting with Heart Failure without Chest Pain: A Case Report

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