Laine Marc, Grisoli Dominique, Bonello Laurent
Hopital Universitaire Nord de Marseille, Marseille, France.
J Invasive Cardiol. 2011 Jul;23(7):305-6.
Most ST-elevation myocardial infarctions are related to atherothrombosis and benefit from emergent percutaneous coronary intervention. On the other hand, type-A aortic dissection is a less frequent but deadly disease requiring emergent surgery. In the present case, we aimed to report the case of a patient who presented with aortic dissection responsible for STEMI and cardiogenic shock related to a compressive hematoma of the left main trunk. This atypical case underlines the need for careful assessment of the aorta in case of left main trunk occlusion in patients without evidence of atheroma in the other coronary segment. Unfortunately, in this case, refractory cardiogenic shock postponed surgical repair and led to the patient's death.
大多数ST段抬高型心肌梗死与动脉粥样硬化血栓形成有关，且从紧急经皮冠状动脉介入治疗中获益。另一方面，A型主动脉夹层是一种不太常见但致命的疾病，需要紧急手术。在本病例中，我们旨在报告一例患者，该患者表现为主动脉夹层导致ST段抬高型心肌梗死和与左主干压迫性血肿相关的心源性休克。这个非典型病例强调，对于其他冠状动脉节段无动脉粥样硬化证据的左主干闭塞患者，需要仔细评估主动脉。不幸的是，在本病例中，难治性心源性休克推迟了手术修复，导致患者死亡。
