Ribbing M, Reinecke H, Breithardt G, Kerber S
Klinik und Poliklinik für Innere Medizin C-Kardiologie und Angiologie, Institut für Arterioskleroseforschung, Universitätsklinikum Münster.
Herz. 2001 Nov;26(7):489-93. doi: 10.1007/s00059-001-2252-8.
After administration methylergometrine 30 minutes after delivery for peripartal vaginal bleeding a 31-year-old female patient developed an acute anterior wall myocardial infarction. Coronary angiography 7 hours after beginning of the chest pain demonstrated a dissection with a large thrombus in the proximal left anterior descending artery, followed by a complete occlusion in the periphery of the vessel (Figure 1). After applying rtPA intravenously, coronary angiography showed 24 hours later an open vessel without thrombotic material (Figure 2).
Coronary artery spasm induced by methylergometrine must be regarded as the main reason for the dissection and thrombus formation followed by a myocardial infarction.
一名31岁女性患者在分娩后30分钟因产后阴道出血使用甲基麦角新碱后发生急性前壁心肌梗死。胸痛开始7小时后进行冠状动脉造影，显示左前降支近端有夹层伴大血栓形成，随后血管外周完全闭塞（图1）。静脉注射rtPA后，24小时后的冠状动脉造影显示血管通畅，无血栓物质（图2）。
甲基麦角新碱诱发的冠状动脉痉挛必须被视为夹层和血栓形成继而导致心肌梗死的主要原因。
