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心电图无ST段改变的急性支架内冠状动脉血栓形成:一例报告及文献复习

Acute in-stent coronary thrombosis without ST change on electrocardiography: a case report and literature review.

作者信息

Tu Chung-Ming, Chu Kai-Ming, Cheng Cheng-Chung, Han Chih-Lu, Liou Jun-Ting

机构信息

Division of Cardiology, Department of Medicine, Song-Shan Armed Forces General Hospital, Taipei, Taiwan, Republic of China.

出版信息

South Med J. 2010 Mar;103(3):239-41. doi: 10.1097/SMJ.0b013e3181cd5f92.

Abstract

Coronary stent thrombosis is a major complication which occurs in 0.5-1.9% of patients undergoing stent implantation. The case of a 65-year-old male who was admitted to the hospital due to chest pain is presented. A 12-lead electrocardiography showed complete AV block, acute inferior wall, and right ventricle myocardial infarction. Coronary angiography showed total occlusion of the right coronary artery. Successful stent implantation was performed with optimal angiographic result. However, the patient developed chest discomfort and 12-lead electrocardiography showed no ST change. Coronary angiography revealed acute in-stent thrombosis. Another stent implantation was done with optimal angiographic result. Although rarely reported, acute in-stent thrombosis can be life-threatening, especially in cases where there is no ST change. For this reason, careful history taking and prompt coronary angiography may be life-saving.

摘要

冠状动脉支架血栓形成是一种主要并发症,在接受支架植入术的患者中发生率为0.5%-1.9%。本文介绍了一名因胸痛入院的65岁男性病例。12导联心电图显示完全性房室传导阻滞、急性下壁及右心室心肌梗死。冠状动脉造影显示右冠状动脉完全闭塞。成功进行了支架植入,血管造影结果理想。然而,患者出现胸部不适,12导联心电图显示无ST段改变。冠状动脉造影显示急性支架内血栓形成。再次进行了支架植入,血管造影结果理想。尽管急性支架内血栓形成报道较少,但可能危及生命,尤其是在无ST段改变的情况下。因此,仔细询问病史并及时进行冠状动脉造影可能挽救生命。

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