Division of Cardiology, Department of Medicine, UCSF Fresno, Fresno, California 93701, USA.
Catheter Cardiovasc Interv. 2011 Aug 1;78(2):223-7. doi: 10.1002/ccd.22904. Epub 2011 Mar 16.
Spontaneous coronary artery dissection (SCAD) is a rare cause of chest pain and cardiomyopathy. This phenomenon usually occurs during the peripartum period. SCAD associated with exercise and heavy weight lifting is even rarer and has been reported in less than 10 cases in the literature. We describe a case of SCAD associated with heavy weight lifting and exercise in a 29-year-old male who presented with exertional chest pain. The patient subsequently underwent a cardiac catheterization that showed a left ventricular ejection fraction of 40% and a dissection in the left anterior descending (LAD) coronary artery after the first diagonal/septal branch with extension to the distal LAD that wrapped around the apex. He was effectively managed with the combination of medical therapy followed by a few days later with stenting. In summary, diagnosis and treatment of this rare phenomenon is a challenge, but early diagnosis and appropriate management can lead to a successful outcome.
自发性冠状动脉夹层(SCAD)是胸痛和心肌病的罕见病因。这种现象通常发生在围产期。与运动和举重相关的 SCAD 甚至更为罕见,文献中报道的病例不足 10 例。我们描述了一例与举重和运动相关的 SCAD 病例,该病例发生在一位 29 岁男性,表现为劳力性胸痛。患者随后进行了心脏导管检查,显示左心室射血分数为 40%,左前降支(LAD)的第一对角支/间隔支之后出现夹层,延伸至 LAD 远端,包绕心尖。他接受了联合药物治疗,几天后进行了支架置入术,治疗效果显著。总之,这种罕见现象的诊断和治疗具有挑战性,但早期诊断和适当的治疗可以获得良好的结果。