Shaikh Ayaz Hussain, Hanif Bashir, Hassan Khursheed, Nasir Sumaira
Tabba Heart Institute, Karachi.
J Pak Med Assoc. 2012 Aug;62(8):854-6.
The case of a 55 years old, hypertensive, obese female is presented, who came to the emergency department with inferoposterior ST segment elevation myocardial infarction (STEMI) with right ventricular infarction. After thrombolytic therapy, she reperfused but had anginal symptoms on minimal activity. The patient underwent coronary angiogram which showed aneurysmal right coronary artery (RCA) with 60% stenosis and thrombus in mid portion and distal bifurcation of RCA with TIMI III distal blood flow. Left main coronary artery was normal. Left anterior descending (LAD) and Left circumflex (LCX) arteries were also aneurysmal and non obstructive. The patient was started on intravenous heparin and warfarin in view of aneurysmal coronary arteries and large thrombus burden. The patient was discharged home in one week and is doing well at follow up.
本文介绍了一名55岁的高血压肥胖女性病例，她因下后壁ST段抬高型心肌梗死（STEMI）合并右心室梗死前往急诊科就诊。溶栓治疗后，她实现了再灌注，但在轻微活动时仍有胸痛症状。患者接受了冠状动脉造影，结果显示右冠状动脉（RCA）呈瘤样扩张，中段狭窄60%，RCA中段及远端分叉处有血栓，TIMI血流分级为III级。左主干冠状动脉正常。左前降支（LAD）和左旋支（LCX）动脉也呈瘤样扩张且无阻塞。鉴于冠状动脉呈瘤样扩张且血栓负荷较大，患者开始接受静脉肝素和华法林治疗。患者在一周后出院，随访情况良好。
