Vancouver General Hospital.
Catheter Cardiovasc Interv. 2013 Dec 1;82(7):E879-83. doi: 10.1002/ccd.24640. Epub 2013 Mar 28.
Fibromuscular dysplasia (FMD) is a segmental non-atherosclerotic, non-inflammatory vasculopathy typically of small- to medium-muscular arteries. Coronary FMD (CFMD) is believed to be rare. However, we have found an association between spontaneous coronary artery dissection (SCAD) and FMD as the cause of myocardial infarction in ∼25% of young women age <50 years. It is plausible that pre-existing CFMD predisposed these women to SCAD. Definitive diagnosis of CFMD entails autopsy that is obviously impractical, and prior angiographic description does not differentiate superimposed SCAD from obliterative arteriopathy of CFMD. Adjunctive intravascular ultrasound or optical coherence tomography may aid the diagnosis of CFMD and we report the first of such novel images.
纤维肌性发育不良（FMD）是一种节段性非动脉粥样硬化、非炎症性血管病变，通常发生于小至中等大小的肌性动脉。冠状动脉纤维肌性发育不良（CFMD）被认为较为罕见。然而，我们发现自发性冠状动脉夹层（SCAD）与 FMD 之间存在关联，FMD 是导致约 25%年龄<50 岁的年轻女性心肌梗死的原因。先前存在的 CFMD 可能使这些女性易患 SCAD，这是合理的。CFMD 的明确诊断需要进行尸检，但显然不切实际，且先前的血管造影描述无法区分叠加的 SCAD 与 CFMD 的闭塞性动脉病。辅助性血管内超声或光相干断层成像术有助于 CFMD 的诊断，我们报告了首例此类新型图像。
