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[产后第10天自发性冠状动脉夹层:一例报告]

[Spontaneous coronary artery dissection on the 10th post-partum day: a case report].

作者信息

Allagui E, Delmotte P, Joly E, Vachiery J L, Preumont N, Renard M

机构信息

Service de cardiologie, hôpital Erasme, ULB, Route de Lennik 808, 1070 Bruxelles, Belgique.

出版信息

Arch Mal Coeur Vaiss. 2006 Mar;99(3):255-8.

Abstract

Spontaneous coronary artery dissection is a rare cause of myocardial infarction. It most commonly occurs in young women in the peri-partum period. The aetiology remains obscure. The authors describe the case of a 38 year old woman who suffered an inferior wall myocardial infarction on the 10th post-partum day. After failure of thrombolysis, coronary angiography showed dissection of the right coronary artery. An attempted angioplasty was unsuccessful and the patient was treated medically with a favourable clinical outcome. Spontaneous coronary artery dissection should be considered in all young patients without coronary risk factors presenting with acute myocardial ischaemia, especially young women in the peri-partum period. Emergency coronary angiography should be undertaken to establish the diagnosis and orientate appropriate treatment which may be medical, interventional or surgical.

摘要

自发性冠状动脉夹层是心肌梗死的罕见病因。它最常发生在围产期的年轻女性中。病因仍不明确。作者描述了一名38岁女性的病例,该女性在产后第10天发生下壁心肌梗死。溶栓治疗失败后,冠状动脉造影显示右冠状动脉夹层。尝试进行血管成形术未成功,该患者接受药物治疗,临床结果良好。对于所有无冠状动脉危险因素却出现急性心肌缺血的年轻患者,尤其是围产期的年轻女性,均应考虑自发性冠状动脉夹层。应进行急诊冠状动脉造影以明确诊断并指导适当的治疗,治疗方式可能是药物治疗、介入治疗或手术治疗。

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