Pan Alexander L, Fergusson David, Hong Robert, Badawi Ramy A
Division of Cardiology, The John A. Burns School of Medicine, University of Hawaii, Queens Medical Center, Honolulu, HI 96813, USA.
Case Rep Cardiol. 2012;2012:524508. doi: 10.1155/2012/524508. Epub 2012 Aug 15.
Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year-old female who developed two spontaneous coronary dissections while on topical hormonal replacement therapy. The patient had no other risk factors for coronary dissection. After withdrawal from topical hormonal therapy, our patient has done well and has not had recurrent coronary artery dissections over a one-year follow-up period. The potential contributory role of topical hormonal therapy as a cause of spontaneous coronary dissection should be recognized.
自发性冠状动脉夹层是一种罕见病症，通常表现为急性冠状动脉综合征，且常见于与全身雌激素水平升高相关的状态，如妊娠或使用口服避孕药时。虽然局部激素替代疗法可能导致雌激素水平升高，类似于口服避孕药使用时所记录的情况，但尚无局部激素替代疗法导致自发性冠状动脉夹层的报道病例。我们描述了一名53岁女性，她在接受局部激素替代疗法时发生了两次自发性冠状动脉夹层。该患者没有其他冠状动脉夹层的危险因素。停用局部激素治疗后，我们的患者情况良好，在一年的随访期内未出现复发性冠状动脉夹层。应认识到局部激素治疗作为自发性冠状动脉夹层病因的潜在促成作用。
