打嗝;可能很危险!

Abeer M. SHAWKY
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引用次数: 0

摘要

背景:打嗝是一种良性的自限性疾病,但持续时应注意潜在的情况。持续性打嗝的原因多种多样,包括代谢异常、心因性疾病、恶性肿瘤、神经系统病理、药物、肺部疾病或胃肠道病因。它很少被归因于心脏病。病例总结:我们报告一例67岁男性顽固性呃呃病为冠心病的初始症状。他有几周的打嗝史,没有其他症状。超声心动图显示左心室壁运动异常,收缩功能严重受损。他被给予氯丙嗪和抗缺血治疗,并建议在心导管插入术前进行铊活力研究以确认存活或不存活的心肌。他拒绝进一步的评估,并在适当的照顾下出院。这位先生出院后两周因心衰再次入院,原因是服药依从性差。治疗的延误影响了他的生存机会,他的打嗝症状反复出现并持续存在。最后,他在确诊两个月后去世了。讨论:本病例突出了高度怀疑的重要性,特别是在老年糖尿病患者中,打嗝等良性自限性症状只能表现为严重心脏病的症状。即使只有胃肠道症状,也应考虑心脏病;简单的心电图变化和心脏酶升高的形式的调查可能揭示心脏的发现,正如他们在我们的病例中所做的!
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pesky Hiccups; May be Risky!
Background: Hiccups are benign and self-limited condition, but attention should be paid to the underlying conditions when persist. There are various causes of persistent hiccups, including metabolic abnormalities, psychogenic disorders, malignancy, nervous system pathology, medications, pulmonary disorders, or gastrointestinal etiologies. It is rarely attributed to cardiac disease. Case Summary: We report a case of intractable hiccups in a 67 y/o male as the initial symptom of coronary heart disease. He presented with a few-week history of hiccups and no other complaints. Echocardiography demonstrated wall motion abnormalities in the left ventricle with severe impairment of systolic function. He was He was admnistered chlorpromazine and anti-ischemic treatment, and a thallium viability study was advised before cardiac catheterization to confirm viable or nonviable myocardium. He refused further evaluation and was discharged with appropriate care. The gentleman was readmitted for heart failure two weeks after discharge due to poor medication adherence. The delay in treatment had affected his chances of survival, and his hiccuping symptoms had recurred and persisted. Finally, he died after two months from the time of diagnosis. Discussion: This case makes highlights the importance of having a high index of suspicion, especially in elderly diabetic patients where benign self-limiting conditions like hiccups can only present symptoms of severe cardiac disease. Cardiac disease should be considered even when the symptoms are only gastrointestinal; simple investigations in the form of changes in electrocardiogram with cardiac enzyme elevation may disclose the cardiac findings, as they did in our case!
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