Sousa Alexandra, Lopes Ricardo, Silva João Carlos, Maciel M Júlia
Cardiology Department, Centro Hospitalar São João, Porto, Portugal; Faculty of Medicine, Porto University, Porto, Portugal.
Rev Port Cardiol. 2013 Jun;32(6):517-21. doi: 10.1016/j.repc.2012.09.012. Epub 2013 Jun 25.
Spontaneous coronary artery dissection is a rare cause of acute coronary events or sudden cardiac death. The clinical presentation is highly variable and prognosis varies widely, depending mainly on how rapidly it is diagnosed. Prompt treatment is also essential, and includes medical management, percutaneous coronary intervention and surgical revascularization. We describe the case of a young woman presenting with spontaneous coronary artery dissection of the left main coronary artery, first diagnosed as coronary thrombus, who underwent successful percutaneous coronary stenting. This report highlights the need to include spontaneous coronary artery dissection in differential diagnosis of chest pain in young women and that distinguishing between coronary thrombus and coronary artery dissection is not always straightforward. To our knowledge this is the fourth case of left main stenting in a patient with spontaneous coronary artery dissection described in the literature.
自发性冠状动脉夹层是急性冠状动脉事件或心源性猝死的罕见原因。其临床表现高度多变，预后差异很大，主要取决于诊断的速度。及时治疗也至关重要，包括药物治疗、经皮冠状动脉介入治疗和外科血管重建术。我们描述了一例年轻女性患者，其左主干冠状动脉发生自发性夹层，最初被诊断为冠状动脉血栓，最终成功接受了经皮冠状动脉支架置入术。本报告强调了在年轻女性胸痛的鉴别诊断中需要考虑自发性冠状动脉夹层，并且区分冠状动脉血栓和冠状动脉夹层并不总是那么容易。据我们所知，这是文献中描述的第四例自发性冠状动脉夹层患者接受左主干支架置入术的病例。
