文/卡里·尼侖貝格 譯/黃珊珊 審訂/寧一中

1 cardiovascular心血管的。

Vision problems may sometimes be the only symptom a person has of a serious cardiovascular condition, a new case report suggests.

[2] In the case, a 77-year-old man in Greece experienced three short episodes of blurred vision in his right eye. The five-minute episodes stretched over an hour in total, and after each episode, his vision returned to normal.

[3] Concerned about this sudden problem, the man went to the eye clinic at his local hospital.

[4] An eye exam showed that the man’s vision was good, and the pressure within his eyes was normal. But when the man’s pupils22 pupil瞳孔。were dilated and a doctor looked more closely into his eyes, the culprit was revealed: A blood clot was blocking the blood supply in a branch of his retinal3retinal視網(wǎng)膜的。artery44 artery動脈。, according

一項新的病例報告顯示，如果一個人患上了嚴重的心血管疾病，視力問題可能是其唯一的癥狀。

[2]在這個病例中，一位77歲的希臘老人右眼經(jīng)歷了三次短暫的視覺模糊。每次癥狀持續(xù)時間長達五分鐘，三次癥狀的出現(xiàn)總共持續(xù)了一個小時。在每一次短暫的視覺模糊之后，他的視力又恢復正常。

[3]由于擔心這個突然出現(xiàn)的健康問題，他去看了當?shù)蒯t(yī)院的眼科。

[4]視力檢查顯示，這位老人的視力很好。眼壓也屬正常。但是當老人的瞳孔放大，一位醫(yī)生仔細檢查了他的眼睛后，發(fā)現(xiàn)了導致其視力模糊的罪魁禍首：一個血栓阻擋了視網(wǎng)膜動脈一個分支的血液供to the report of the man’s case.

[5] Such clots are typically made out of cholesterol5cholesterol膽固醇。and clumps of platelets66 platelet血小板。(blood cell fragments), and in the case,the clot came from the man’s carotid7carotid頸動脈的。artery, the main artery that brings blood to the head and neck, said Dr. Ilias Georgalas, an assistant professor of ophthalmology88 ophthalmology眼科。at the National and Kapodistrian University of Athens, in Greece.

[6] But the tiny clot was a serious health problem—people with a blockage in the eye’s central or branch retinal artery have a high risk of a serious or fatal stroke9stroke中風。, said Georgalas, who treated the man and was one of the coauthors of the case report published on-Nov. 25 in theNew England Journal of Medicine.應(yīng)，病例報告中這樣寫道。

[5]希臘雅典大學眼科助理教授伊利亞斯·耶奧加拉斯醫(yī)生說，通常情況下，這種血栓是由膽固醇和許多血小板（血液細胞碎片）構(gòu)成。在這個病例中，血栓來源于老人的頸動脈，而頸動脈是將血液輸送到頭部和頸部的主要動脈。

[6]耶奧加拉斯醫(yī)生寫道，小小的血栓卻造成了嚴重的健康問題——如果視網(wǎng)膜中央動脈或其分支阻塞，人們患上嚴重甚至是致命中風的機率非常高。耶奧加拉斯醫(yī)生治療了這位老人，并且是該病例報告的共同作者之一。該報告已經(jīng)于11月25日被在線發(fā)表在《新英格蘭醫(yī)學期刊》上。

Vision problems and heart disease

[7] The case highlights the fact that visual symptoms can be a warning sign of a cardiovascular problem, Georgalas told Live Science.

[8] The 77-year-old man had no history of eye problems, but he had high cholesterol levels and had been taking statin drugs10statin drugs他汀類藥物。for the past five years to reduce his cholesterol.

[9] The man was diagnosed with “amaurosis fugax”11一時性黑蒙，表現(xiàn)為頭暈，視物模糊，突然出現(xiàn)的雙目失明，視野缺失經(jīng)常在5—19分完全恢復。, a condition in which a

視力問題和心臟病

[7]耶奧加拉斯醫(yī)生告訴美國生命科學網(wǎng)，這個病例突出反映了這樣一個事實，即視力問題可能是心血管疾病的一個警告信號。

[8]這位77歲的老人沒有眼部疾病史，但是他的膽固醇很高，并且在過去的五年內(nèi)一直在服用他汀類藥物來降低膽person loses vision in one eye, usually for a few minutes at a time, because of an interruption of blood flow in an artery.

[10] The clot in the man’s eye was a fragment of a plaque12plaque血小板，斑塊。that had formed in the man’s right carotid artery, and then traveled through his bloodstream and landed in one of the smaller branches of the retinal artery in his eye, Georgalas said. This temporarily closed off the blood supply to his right eye, which explains the man’s blurred vision, he said.

[11] Examining the eyes is an easy way for doctors to have a look at the vascular13vascular血管的。system, the network of blood vessels in the body, which includes the arteries and veins, Georgalas said. It’s very rare for a vascular problem in other parts of the body to not be seen in the blood vessels within the eyes, he said.

[12] For this Greek man, his blurred vision led doctors to detect that the blood flow through his right internal carotid artery was 80 percent blocked because of atherosclerosis14atherosclerosis動脈粥樣硬化。, or hardening of the arteries.

[13] He needed a carotid endarterectomy15endarterectomy動脈內(nèi)膜切除術(shù)。, a surgical procedure that removes plaque buildup in a narrowed artery, and can prevent a stroke. Twelve months later, the man’s vision was固醇。

[9]這位老人被診斷出患有“一時性黑蒙”，即一只眼睛因為視網(wǎng)膜動脈內(nèi)供血中斷而失去視力，一次癥狀通常持續(xù)幾分鐘。

[10]耶奧加拉斯說，老人眼中的血栓是一個血小板的碎片，這個碎片形成于老人右側(cè)頸動脈，之后通過血液流動到視網(wǎng)膜動脈一個較小的分支中。這就暫時阻礙了右眼的供血，導致老人視力模糊。

[11]耶奧加拉斯說，對于醫(yī)生來說，檢查眼睛是一種簡單的檢查血管系統(tǒng)的方法。血管系統(tǒng)是人體內(nèi)的血管網(wǎng)絡(luò)，它包括動脈和靜脈。人體其他部位的血管疾病絕大多數(shù)都會在眼部血管中表現(xiàn)出來。

[12]鑒于這位希臘老人視線模糊的癥狀，醫(yī)生發(fā)現(xiàn)，因為動脈粥樣硬化或動脈硬化，老人右側(cè)頸內(nèi)動脈80%的血液已經(jīng)被阻塞。

[13]我們了解到老人需要做一個頸動脈內(nèi)膜切除手術(shù)，這種外科手術(shù)會在狹窄的動脈內(nèi)去除聚集的斑塊，并且預(yù)防中風。根據(jù)病例報告，一年之后，這位老人的視力恢復正常，normal and he had no eye problems, according to the case.

[14] For a relatively high number of people with severe carotid artery blockage, temporary visual loss may be the only symptom, Georgalas said.

[15] Any temporary, painless loss of vision should not be ignored, he said. The eyes can provide a good indication of a person’s health throughout the body, and visiting an ophthalmologist16ophthalmologist眼科醫(yī)生。can often be the fi rst step in diagnosing more severe health problems, Georgalas noted. ■并且沒有眼部疾病。

[14]耶奧加拉斯說，相當多嚴重頸動脈阻塞患者的唯一癥狀就是短暫性失明。

[15]耶奧加拉斯說，我們不應(yīng)該忽視任何無痛的短暫性失明癥狀。眼睛可以很好地顯示一個人的身體健康狀況。因此，看眼科醫(yī)生往往是診斷更嚴重健康問題的第一步。 □