Schmid Julia, Auer Johann
Department of Cardiology and Intensive Care, General Hospital Braunau, Austria, Ringstrasse 60, A - 5280 Braunau am Inn, Austria.
J Cardiothorac Surg. 2011 Mar 3;6:22. doi: 10.1186/1749-8090-6-22.
A 31 year old man with a 17-year-history of drug abuse (heroine and cannabis) was admitted with recurrent chest pain over a period of about three weeks. Chest discomfort severely worsened during the 5 hours before hospital admission. Electrocardiography revealed poor R-wave progression and non specific repolarization abnormalities. Echocardiography showed extensive left ventricular anterior and apical wall motion abnormalities and a ventricular thrombus located at the apex of the left ventricle was present. Subsequently, a diagnosis of acute coronary syndrome was made. Coronary angiography revealed spontaneous coronary artery dissection of the left anterior descending (LAD) artery with Thrombolysis In Myocardial Infarction (TIMI) flow 2 to 3. We managed the patient conservatively. The clinical course was uneventful and repeated angiography on day 4 demonstrated spontaneous healing of large parts of the dissection with TIMI 3 flow in the LAD.
一名有17年药物滥用史（海洛因和大麻）的31岁男性，因在约三周时间内反复出现胸痛入院。在入院前5小时，胸部不适严重加剧。心电图显示R波进展不良和非特异性复极异常。超声心动图显示广泛的左心室前壁和心尖壁运动异常，左心室心尖处存在心室血栓。随后，诊断为急性冠状动脉综合征。冠状动脉造影显示左前降支（LAD）动脉自发性冠状动脉夹层，心肌梗死溶栓（TIMI）血流为2至3级。我们对该患者进行了保守治疗。临床过程平稳，第4天重复造影显示夹层大部分自发愈合，LAD血流为TIMI 3级。
