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因冠状动脉发育不良导致的青年人心肌梗死。

Myocardial Infarction in a Young Man due to a Hypoplastic Coronary Artery.

机构信息

The Heart Center of Chonnam National University Hospital, Cardiovascular Research Institute of Chonnam National University, Gwangju, Korea.

出版信息

Korean Circ J. 2009 Apr;39(4):163-7. doi: 10.4070/kcj.2009.39.4.163. Epub 2009 Apr 28.

DOI:10.4070/kcj.2009.39.4.163
PMID:19949606
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2771812/
Abstract

Hypoplastic coronary artery disease (HCAD) is a rare condition that may lead to myocardial infarction (MI) and sudden death. We discovered HCAD in a young man who developed chest pain after heavy drinking and who was found to have suffered an MI. His ECG showed ST-segment elevation with Q waves in the anterior leads, and echocardiography revealed apical dyskinesia with moderate left ventricular (LV) dysfunction. Coronary angiography showed hypoplasia of the left anterior descending (LAD) artery. (99m)Tc-tetrofosmin-gated myocardial perfusion scintigraphy showed a large, fixed perfusion defect in the anteroseptal and apical segments. Sixty-four-slice cardiac CT and cardiac MR imaging demonstrated thinning of the apical wall with calcification and delayed enhancement, supporting the diagnosis of long-standing MI. The patient was discharged symptom-free on medication for ischemic heart failure two weeks after admission. Although HCAD is very uncommon, it should be considered in children and young adults who suffer MI or sudden cardiac death.

摘要

发育不良性冠状动脉疾病（HCAD）是一种罕见的病症，可能导致心肌梗死（MI）和猝死。我们在一名年轻男性中发现了 HCAD，他在大量饮酒后出现胸痛，并被发现患有 MI。他的心电图显示前导 ST 段抬高伴 Q 波，超声心动图显示心尖部运动障碍伴中度左心室（LV）功能障碍。冠状动脉造影显示左前降支（LAD）发育不良。（99m）Tc-四氮脒门控心肌灌注闪烁显像显示前间隔和心尖段有大而固定的灌注缺损。64 层心脏 CT 和心脏磁共振成像显示心尖壁变薄伴钙化和延迟强化，支持陈旧性 MI 的诊断。该患者在入院两周后因缺血性心力衰竭接受药物治疗后无症状出院。尽管 HCAD 非常罕见，但在患有 MI 或心源性猝死的儿童和年轻成年人中应考虑到这种疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a72c/2771812/5440d4cfef7e/kcj-39-163-g008.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a72c/2771812/7b165be81f02/kcj-39-163-g005.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a72c/2771812/5695321705e9/kcj-39-163-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a72c/2771812/5440d4cfef7e/kcj-39-163-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a72c/2771812/107a3a674645/kcj-39-163-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a72c/2771812/20dde288467b/kcj-39-163-g003.jpg
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