以晕厥为首发症状的老年急性肺栓塞1例

Elderly acute pulmonary thromboembolism initially presenting as syncope： a case report

1病例摘要 姚某某，女，80岁，因“反复发作意识障碍1天”入院，入院前1天，患者口服降压药并排尿后突发意识不清，近1min，无抽搐、排尿、排便失禁及舌咬伤，神志自行恢复。但自觉乏力、冷汗、胸闷气短，遂就诊于我院急诊科。急诊心电图、心肌酶正常。予硝酸酯类药物治疗，患者拒绝急诊留观。回家后上述症状再发5次。

Case presentation Yao, 80-year-old female, was admitted to the hospital due to the reduplicated disturbance of consciousness. One day before admission, the patient suddenly collapsed and lost consciousness for approximately 1 minute after oral hypotensor and micturition, without tic, incontinence, or bite injury of tongue. She came to Emergency Depart- ment of our hospital after her consciousness recovered spontaneously, as she felt weakness, diaphoretic and short of breath. Electrocardiogram （ECG） （emergency） and cardiac enzymes of serum were found normal. The patient refused to stay in Emergency Department for further observation before finishing intravenous nitroglycerine. The similar episode attacked 5 times after she went home.