医学界心血管频道|快看!心脏“漏了个洞”,人竟然还活着……( 二 )
当然 , 本人无意苛责 。
这年头 , 即使是在心脏专科门诊 , 要进行质量良好的心脏听诊 , 也要受限于患者配合度、环境是否安静、时间是否充裕等 , 何况还有其他因素 , 胸部听诊还是有些难的 。
这患者也正是奇 , 肠系膜上动脉栓塞了 , 却无肠道缺血 , 右髂总动脉栓塞了 , 也无右下肢缺血 。
如此霰弹 , 脑部却奇迹般的豁免了 。
要知道普通人每次心跳四分之一的供血可是向着脑部的 。
接下来 , 治疗方案明确 , 长程、足量抗生素 , 加外科手术处理瓣膜病变 。
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参考文献:
[1].Seferovic PM, Fragasso G, Petrie M, Mullens W, Ferrari R, Thum T, Bauersachs J, Anker SD, Ray R, Cavusoglu Y et al: Sodium glucose co-transporter-2 inhibitors in heart failure: beyond glycaemic control. The Position Paper of the Heart Failure Association of the European Society of Cardiology. European journal of heart failure 2020.
[2].Hallow KM, Helmlinger G, Greasley PJ, McMurray JJV, Boulton DW: Why do SGLT2 inhibitors reduce heart failure hospitalization? A differential volume regulation hypothesis. Diabetes, obesity & metabolism 2018, 20(3):479-487.
[3].Yurista SR, Sillje HHW, van Goor H, Hillebrands JL, Heerspink HJL, de Menezes Montenegro L, Oberdorf-Maass SU, de Boer RA, Westenbrink BD: Effects of Sodium-Glucose Co-transporter 2 Inhibition with Empaglifozin on Renal Structure and Function in Non-diabetic Rats with Left Ventricular Dysfunction After Myocardial Infarction. Cardiovascular drugs and therapy 2020, 34(3):311-321.
[4].Iborra-Egea O, Santiago-Vacas E, Yurista SR, Lupon J, Packer M, Heymans S, Zannad F, Butler J, Pascual-Figal D, Lax A et al: Unraveling the Molecular Mechanism of Action of Empagliflozin in Heart Failure With Reduced Ejection Fraction With or Without Diabetes. JACC Basic to translational science 2019, 4(7):831-840.
[5].Li C, Zhang J, Xue M, Li X, Han F, Liu X, Xu L, Lu Y, Cheng Y, Li T et al: SGLT2 inhibition with empagliflozin attenuates myocardial oxidative stress and fibrosis in diabetic mice heart. Cardiovascular diabetology 2019, 18(1):15.
[6].Verma S, Mazer CD, Yan AT, Mason T, Garg V, Teoh H, Zuo F, Quan A, Farkouh ME, Fitchett DH et al: Effect of Empagliflozin on Left Ventricular Mass in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease: The EMPA-HEART CardioLink-6 Randomized Clinical Trial. Circulation 2019, 140(21):1693-1702.
[7].Brown AJM, Lang C, McCrimmon R, Struthers A: Does dapagliflozin regress left ventricular hypertrophy in patients with type 2 diabetes? A prospective, double-blind, randomised, placebo-controlled study. BMC cardiovascular disorders 2017, 17(1):229.
[8].Pabel S, Wagner S, Bollenberg H, Bengel P, Kovacs A, Schach C, Tirilomis P, Mustroph J, Renner A, Gummert J et al: Empagliflozin directly improves diastolic function in human heart failure. European journal of heart failure 2018, 20(12):1690-1700.
[9].Packer M: Do sodium-glucose co-transporter-2 inhibitors prevent heart failure with a preserved ejection fraction by counterbalancing the effects of leptin? A novel hypothesis. Diabetes, obesity & metabolism 2018, 20(6):1361-1366.
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