D'Ovidio Cristian, Sablone Sara, Carnevale Aldo
Section of Legal Medicine, Department of Medicine and Aging Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy.
J Forensic Sci. 2015 May;60(3):801-6. doi: 10.1111/1556-4029.12722. Epub 2015 Feb 10.
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction and sudden cardiac death. It occurs most commonly in otherwise healthy women during pregnancy or the postpartum period. The true incidence of SCAD is underestimated, as most cases are diagnosed at autopsy. The pathophysiology of SCAD is still not fully understood, and its management can be challenging. This report describes a 35-year-old pregnant female who presented with an acute antero-lateral ST elevation secondary to spontaneous dissection of the left anterior descending artery and the circumflex artery. The diagnosis was established by coronary artery angiography. However, the patient died following cardiac tamponade. The examination of this case represented a starting point for the reviewing of the diagnosis, clinical course, and management of SCAD, and for the placing of this in context with the existing literature. This study highlights the importance of prompt diagnosis and subsequent lifesaving treatment.
自发性冠状动脉夹层（SCAD）是急性心肌梗死和心源性猝死的罕见原因。它最常发生在孕期或产后的健康女性身上。由于大多数病例是在尸检时才被诊断出来，所以SCAD的实际发病率被低估了。SCAD的病理生理学仍未完全了解，其治疗也具有挑战性。本报告描述了一名35岁的孕妇，她因左前降支和回旋支自发性夹层而出现急性前侧壁ST段抬高。通过冠状动脉造影确诊。然而，患者因心脏压塞死亡。对该病例的检查是回顾SCAD的诊断、临床过程和治疗，并将其与现有文献相结合的起点。本研究强调了及时诊断和后续挽救生命治疗的重要性。
