Misdiagnosis one cases of acute pulmonary embolism Analysis.doc

 PAGE \* MERGEFORMAT 5 Misdiagnosis one cases of acute pulmonary embolism Analysis [Keywords:] Pulmonary embolism Acute pulmonary embolism is due to endogenous or exogenous emboli blocking pulmonary trunk or branch pulmonary circulation disorder caused by clinical and pathological physiological syndrome, its incidence second only to coronary heart disease and high blood pressure, the mortality rate ranks third, only secondary to cancer and myocardial infarction, but the long-term prevention and treatment of disease due to lack of sufficient attention, particularly grass-roots hospitals often missed, misdiagnosed. Clinical experience has shown that, where the original symptoms of sudden heart and lung diseases aggravated or sudden difficulty breathing, and through the corresponding cardiac, diuretic, vasodilator effects of such treatment is not obvious cases, especially those long-term bed rest, accompanied by atrial fibrillation or severe cardiac insufficiency, the use of a large number of diuretics, there are clear signs of dehydration or leg swelling, and even more should take into account the possibility of pulmonary embolism. A clinical data Patients, male, 59 years old, past history of coronary heart disease for 5 years. Paroxysmal chest tightness, suffocation 2 days after the event once a hospital syncope. Palpation: T36.8 ℃ , blood pressure 130/80mmHg, breathing 22 times / min. Acute tolerance, wheezing like. Lips cyanosis. Skin and mucosa stained, no bleeding point and ecchymosis, superficial lymph nodes less than. Lungs can be heard and the dry nature of rales, apex beat normal, does not touch on tremor, heart little circles, heart rate, an average of 110 times / min, arrhythmias, heart sounds strong or weak, depending on the valve auscultation area is not known and pathological murmur . Plain abdominal soft, liver and spleen is not, both lower extremities and swelling. Laboratory tests: hemoglobin, white blood cells 1.2 * 109 / L, which accounted