Lodha Ankur, Mirsakov Nina, Malik Bilal, Shani Jacob
Department of Internal Medicine and Division of Cardiology, Maimonides Medical Center, Brooklyn, NY 11219, USA.
South Med J. 2009 Mar;102(3):315-7. doi: 10.1097/SMJ.0b013e318197b6be.
Spontaneous coronary artery dissection (SCAD) is a deadly cause of myocardial infarction (MI) that mainly affects otherwise healthy, young females. We examine the case of a young female who presented with chest pain. She developed ST elevations in anterolateral leads mimicking ST elevation MI. Cardiac catheterization was done and showed a proximal left anterior descending (LAD) dissection. The patient underwent primary percutaneous transluminal coronary angioplasty with four paclitaxel-eluting coronary stents placed in the LAD. Diagnosis and management of SCAD have remained a challenge and no guidelines have yet been proposed due to the rarity and uncertain etiology of this condition. We review the medical literature on spontaneous coronary artery dissection and discuss its pathogenesis.
自发性冠状动脉夹层（SCAD）是心肌梗死（MI）的一个致命原因，主要影响原本健康的年轻女性。我们研究了一名出现胸痛的年轻女性病例。她前侧壁导联出现ST段抬高，酷似ST段抬高型心肌梗死。进行了心脏导管插入术，结果显示左前降支（LAD）近端夹层。该患者接受了急诊经皮冠状动脉腔内血管成形术，并在LAD置入了4个紫杉醇洗脱冠状动脉支架。由于SCAD这种疾病罕见且病因不明，其诊断和管理仍然是一个挑战，目前尚未提出相关指南。我们回顾了关于自发性冠状动脉夹层的医学文献并讨论其发病机制。
