周末读书会：可怕的呼吸困难

A 65-year-old woman presented to the emergency department with worsening dyspnea on exertion. She had a history of deep venous thrombosis and within the past month had been traveling extensively. Examination was notable for dyspnea without unilateral leg swelling or jugular venous distention, a room air oxygen saturation of 92%, and tachycardia of 102 beats/min. D-dimer level was elevated, at 2,636 ng/mL. Computed tomography (CT) pulmonary angiography confirmed the diagnosis.

65岁女性患者来急诊室就诊，主诉为活动后呼吸苦难逐渐加重。这位患者有深静脉血栓的病史，过去一个月有过长途旅行。体检未发现明显的单侧下肢肿胀以及颈静脉怒张，室内空气，氧饱和度92%，心率102次/分。D二聚体升高，2636mg/ml。CTPA确证肺栓塞。

Figure2 血栓通过了未闭的卵圆孔。Figure3 降主动脉血栓。