A 77-Year-Old Female Presented with Atypical Chest Pain

Abstract

<p>心血管疾病在血液透析患者的共病中佔42.8%，胸痛是常見的主訴，除了冠心症這類常見的原因外，近年來因血管通路置放支架普遍化後所產生的相關併發症也需考慮在內。本案例是一位73歲女性，因胸痛經歷心臟內科、胸腔內科、腸胃內科及急診求治後，最後是血管通路置放支架移位至肺動脈所引起。個案在轉介後雖進行經皮手術，但因沾黏厲害導致手術未能取出支架，後續口服抗凝血劑合併門診追蹤治療，目前病況穩定未有嚴重併發症發生。因此藉由此案例，讓臨床醫護人員在照護血液透析族群主訴胸痛時，能注意支架移位的可能性，及早發現並適時處置。</p> <p> </p><p>Cardiovascular diseases account for 42.8% of the comorbidities in hemodialysis patients. Chest pain is a common chief complaint, in addition to common causes such as coronary heart diseases, complica-tions of vascular access stent migration should also be considered. This case is a 73-year-old woman presented with chest pain. After visiting Cardiology, Chest Medicine, Gastroenterology and Emergen-cy Department, stent migration from arteriovenous graft to the bilateral pulmonary artery was diag-nosed. After referred to a surgeon, percutaneous retrieval surgery was failed due to severe adhesion. Thus, oral anticoagulant was applied along with outpatient follow-up. Then, the patient’s condition was stable without serious complications. The aim of this study is to remind clinical staff to pay attention to stent migration when hemodialysis population complaining of chest pain for earlier detection and proper treatments.</p> <p> </p>