左前降支冠状动脉痉挛及类似冠状动脉夹层的“手风琴效应”

Left anterior descending coronary artery spasm and "accordion effect" mimicking coronary artery dissection.

作者信息

Valuckienė Zivilė, Vasylius Tomas, Unikas Ramūnas

机构信息

Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2014;50(5):309-11. doi: 10.1016/j.medici.2014.10.004. Epub 2014 Oct 29.

DOI:10.1016/j.medici.2014.10.004

PMID:25488168

Abstract

We present an illustrative case report of the mid-vessel left anterior descending (LAD) coronary artery spasm, which has been enhanced by straightening of the tortuous LAD segment with a guidewire ("accordion effect") thus resistant to intracoronary nitroglycerine and mimicking a coronary artery dissection. Dynamic appearance of this iatrogenic pseudo-lesion upon administration of intracoronary nitrates and recognition of these angiographic phenomena prevented from unnecessary further intervention.

摘要

我们展示了一例左前降支（LAD）冠状动脉血管中段痉挛的典型病例报告，该段迂曲的LAD节段通过导丝变直（“手风琴效应”）而加重痉挛，从而对冠状动脉内硝酸甘油耐药，并酷似冠状动脉夹层。冠状动脉内给予硝酸盐后这种医源性假性病变的动态表现以及对这些血管造影现象的识别避免了不必要的进一步干预。