主動脈夾層 Aortic Dissection 教育頭條網

主動脈夾層 Aortic Dissection

【Aortic Dissection 主動脈夾層】

Suprapubic adj.恥骨上的

Troponin n.肌鈣蛋白

Mediastinum n.縱膈

Dilatation n.擴張

Flap n.皮瓣

Beta-blocker n.β受體阻滯劑

An 81-year-old man with no documented medical history presented to the emergency department with suprapubic pain and urinary retention resulting from benign prostatic hyperplasia. He was incidentally found to have an elevated troponin I level, at 0.17 ng per milliliter (normal value less than 0.08 ). He reported no chest or back pain or shortness of breath. There was no evidence of ischemic changes on electrocardiography. Chest radiography showed widening of the mediastinum. Transthoracic echocardiography showed aneurysmal dilatation and a dissection flap in the ascending aorta(see the video at NEJM.org). Computed tomographic angiography of the thorax and abdomen revealed an ascending aortic aneurysm and a type I DeBakey aortic dissection. The dissection involved the ascending aorta, aortic arch, and descending aorta, terminating just below the origin of the renal arteries. Given the absence of associated symptoms, the dissection was thought to be chronic. The patient declined consideration of surgical intervention but agreed to treatment with a beta-blocker. One year later, the patient's condition had not worsened; he continued to be treated with a beta-blocker and to receive routine follow-up care.¹

【譯文】一名81歲無疾病史記錄男性，因良性前列腺增生所致恥骨上疼痛和尿瀦留就診於急診科。偶然發現患者肌鈣蛋白I水平升高，為0.17納克/毫升（正常值小於0.08）。患者無胸痛或者背痛或呼吸急促。心電圖無缺血性改變的證據。胸片顯示縱膈增寬。經胸超聲心動圖顯示升主動脈的動脈瘤樣擴張和夾層瓣（在NEJM.org觀看視頻）。胸部和腹部計算機斷層掃描血管造影顯示升主動脈瘤和DeBakey I型主動脈夾層。夾層累及升主動脈、主動脈弓和降主動脈，終止部位略低於腎動脈起始處。考慮到患者無主動脈夾層相關症狀，認為夾層是慢性的。患者拒絕考慮外科手術，但是同意β受體阻滯劑治療。一年後，患者病情沒有惡化，他繼續β受體阻滯劑治療，並且定期接受隨訪。

【醫學單詞記憶之道】

1. 醫學單詞記憶

supra-前綴在…之上

suprarenal adj.腎上的

supraventricular adj.室上性的

suprapubic adj.恥骨上的

supraclavicular adj.鎖骨上的

supramaxilla n.上顎

2. 常用醫學詞組

aortic Dissection 主動脈夾層

urinary retention 尿瀦留

benign prostatic hyperplasia