曾接受冠状动脉旁路移植术的患者因严重低血压和左锁骨下动脉近端狭窄导致的ST段抬高型急性心肌梗死。

ST-Segment elevation acute myocardial infarction due to severe hypotension and proximal left subclavian artery stenosis in a prior coronary artery bypass graft patient.

作者信息

Dimas Billy, Lindsey Jason B, Banerjee Subhash, Brilakis Emmanouil S

机构信息

VA North Texas Healthcare System, Dallas, TX 75216, USA.

出版信息

Cardiovasc Revasc Med. 2009 Jul-Sep;10(3):191-4. doi: 10.1016/j.carrev.2008.08.003.

DOI:10.1016/j.carrev.2008.08.003

PMID:19595403

Abstract

Proximal subclavian artery stenosis may result in cardiac ischemia in coronary artery bypass graft patients with internal mammary grafts. We report a case of acute anterior myocardial infarction in such a patient who developed severe systemic hypotension. Symptoms and electrocardiographic changes resolved after proximal left subclavian artery stenting. Subclavian angiography should be considered in all prior coronary artery bypass graft patients with internal mammary grafts undergoing coronary angiography.

摘要

在采用乳内动脉移植物的冠状动脉旁路移植术患者中，近端锁骨下动脉狭窄可能导致心脏缺血。我们报告了一例此类患者发生急性前壁心肌梗死并出现严重全身性低血压的病例。在对左锁骨下动脉近端进行支架置入术后，症状和心电图改变得以缓解。对于所有既往接受过冠状动脉旁路移植术且采用乳内动脉移植物并正在接受冠状动脉造影的患者，均应考虑进行锁骨下动脉血管造影。