多巴酚丁胺负荷超声心动图检查结果为阴性后发生急性心肌梗死。

Acute myocardial infarction after a negative dobutamine stress echocardiogram.

作者信息

Elhendy Abdou, Ginete Wilson, Shurmur Scott, Porter Thomas R

机构信息

Department of Internal Medicine, Section of Cardiology, University of Nebraska Medical Center, Omaha, NE 68198-2265, USA.

出版信息

Eur J Echocardiogr. 2004 Dec;5(6):469-71. doi: 10.1016/j.euje.2004.04.006.

DOI:10.1016/j.euje.2004.04.006

PMID:15556823

Abstract

Acute myocardial infarction is a rare complication of dobutamine stress echocardiography (DSE). We described angiographic findings of a patient who developed acute inferior ST segment elevation myocardial infarction 2h after a normal dobutamine stress echocardiogram. The patient failed thrombolysis and underwent coronary angiography, which showed 60% stenosis of proximal right coronary artery with a complex ulcerated lesion and intracoronary thrombus. These findings suggest that myocardial infarction following DSE does not necessarily occur in patients with severe obstructive coronary artery disease. High shear stress may result in destabilization of a complex plaque with subsequent thrombotic occlusion, despite the absence of a flow-limiting lesion at the time of DSE.

摘要

急性心肌梗死是多巴酚丁胺负荷超声心动图（DSE）的一种罕见并发症。我们描述了一名患者的血管造影结果，该患者在多巴酚丁胺负荷超声心动图检查结果正常2小时后发生急性下壁ST段抬高型心肌梗死。患者溶栓治疗失败并接受了冠状动脉造影，结果显示右冠状动脉近端有60%的狭窄，伴有复杂的溃疡性病变和冠状动脉内血栓形成。这些发现表明，DSE后发生的心肌梗死不一定发生在患有严重阻塞性冠状动脉疾病的患者中。尽管在DSE时没有血流限制性病变，但高剪切应力可能导致复杂斑块不稳定，随后发生血栓性闭塞。