Heseltine Thomas David, Karthikeyan Vellore J, Morris John
Department of Medicine, Leighton Hospital, Crewe, UK.
BMJ Case Rep. 2014 Apr 25;2014:bcr2013203145. doi: 10.1136/bcr-2013-203145.
We describe the case of a 65-year-old patient who was admitted to our tertiary centre with cardiac sounding chest pain and inferior ST elevation. Coronary angiography revealed mild plaque disease in the left anterior descending artery. The right coronary artery was smooth with no plaques with the exception of an occluded distal branch with no flow. The left ventriculogram revealed a ballooned and akinetic apex typical of Takotsubo syndrome (TS). We suspected a coronary embolus secondary to TS. A serial rise and fall in biomarkers of myocardial necrosis was noted. The patient was treated for acute coronary syndrome and discharged home 72 h from admission. Distal thromboembolism has been described in the literature before. On a search of PubMed there are no examples of coronary artery embolus in the context of TS.
我们描述了一名65岁患者的病例,该患者因心脏听诊胸痛和下壁ST段抬高入住我们的三级医疗中心。冠状动脉造影显示左前降支动脉有轻度斑块病变。右冠状动脉光滑,无斑块,除了一个闭塞的远端分支且无血流。左心室造影显示典型的Takotsubo综合征(TS)的球囊样和运动减弱的心尖。我们怀疑是TS继发的冠状动脉栓塞。观察到心肌坏死生物标志物呈系列性升高和下降。该患者接受了急性冠状动脉综合征的治疗,并在入院72小时后出院回家。之前文献中已描述过远端血栓栓塞。在检索PubMed时,没有TS背景下冠状动脉栓塞的实例。