3例致死性不明原因心包积血诊疗难点分析

Difficulties in diagnosis and treatment of fatal pericardial hemorrhage of unknown origin:3 cases report

1病例资料收集我院急诊2018年10月以来收治的3例不明原因心包积血致死患者,黄某(A),老年男性,66岁,因反复胸闷1周,突发晕厥1次,胸痛4h入院,初诊:①急性心肌梗死待排-Killip Ⅳ级;②心包积血;③高血压病3级(很高危组)。

We analyzed the experience in the diagnosis and treatment of fatal pericardial hemorrhage without definite cause of bleeding.The diagnosis and treatment of three cases of fatal unidentified pericardial hemorrhage in emergency department were retrospectively analyzed.The bleeding sites were examined by echocardiography,chest CT or CTA.All three patients died of cardiac tamponade within 48 hours of conservative treatment,and no bleeding site was identified.For patients with unexplained pericardial hemorrhage whose condition can not be stabilized by conservative treatment,acute aortic syndrome with cardiac tamponade should be considered,and surgical treatment should be performed if necessary.