Emerg Med J. 2010 Feb;27(2):161-3. doi: 10.1136/emj.2008.066209.
Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischaemia with a high mortality. It most commonly occurs in young women with few risk factors for atherosclerosis. Presentation is varied, from sudden death to chest pain with features of myocardial ischaemia. The case presented highlights the dilemma of the need to treat a myocardial infarction within an acceptable time frame versus exploring a rare but entirely possible pathology, which may only be diagnosed in a tertiary referral centre a minimum of 90 min away.
自发性冠状动脉夹层（SCAD）是一种罕见的心肌缺血病因，其死亡率较高。它最常发生于年轻女性，且很少存在动脉粥样硬化的危险因素。临床表现多样，从猝死到胸痛伴心肌缺血特征。本病例突显了在可接受的时间范围内治疗心肌梗死与探索罕见但完全可能的病理之间的困境，而这种病理只有在至少 90 分钟车程之外的三级转诊中心才能明确诊断。
