Innami R, Nagaoka H, Oonuki M, Manabe S
Department of Thoracic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Surg Today. 1999;29(10):1120-4. doi: 10.1007/s005950050657.
A young Japanese woman who appeared to be free from any coronary risk factors was admitted to a local hospital with chest pain. Serological tests showed no evidence of inflammation; however, an electrocardiogram revealed diffuse myocardial ischemia and a coronary angiogram demonstrated isolated bilateral coronary ostial stenoses. Moreover, her serum creatine phosphokinase level was high. On the day following admission, the patient developed severe cardiogenic shock, and she was transferred to our hospital where emergency coronary artery bypass grafting with the saphenous veins was performed using retrograde tepid blood cardioplegia. Recovery of cardiac function was immediate and her postoperative course was uneventful. We suspect that fibromuscular dysplasia was the most likely cause of the ostial stenoses in this patient.
一名看似没有任何冠心病危险因素的年轻日本女性因胸痛入住当地医院。血清学检查未发现炎症迹象；然而，心电图显示弥漫性心肌缺血，冠状动脉造影显示孤立性双侧冠状动脉开口狭窄。此外，她的血清肌酸磷酸激酶水平很高。入院后的第二天，患者出现严重的心源性休克，随后被转至我院，在逆行微温血液心脏停搏的情况下使用大隐静脉进行了急诊冠状动脉旁路移植术。心脏功能立即恢复，术后过程顺利。我们怀疑纤维肌性发育异常是该患者冠状动脉开口狭窄的最可能原因。
