Malcles G, Combaret N, Motreff P
Department of Cardiology, Gabriel-Montpied Hospital, Clermont-Ferrand University Hospital, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
Ann Cardiol Angeiol (Paris). 2015 Dec;64(6):467-71. doi: 10.1016/j.ancard.2015.09.054. Epub 2015 Oct 23.
Spontaneous coronary artery dissection (SCAD) is a poorly understood and under-diagnosed entity of acute coronary syndrome, affecting predominantly young women. On coronary angiography, the diagnosis remains challenging, particularly in case of intramural hematoma without intimal rupture. Intracoronary imaging, especially by optical coherence tomography (OCT), provides an incremental value in terms of diagnosis and management. We report the case of a 49-year-old woman admitted for STEMI caused by an intramural hematoma. In the discussion part, we aim to review the epidemiology, physiopathology, diagnosis, management and long-term prognosis of SCAD.
自发性冠状动脉夹层（SCAD）是一种对其了解甚少且诊断不足的急性冠状动脉综合征，主要影响年轻女性。在冠状动脉造影检查中，诊断仍然具有挑战性，尤其是在没有内膜破裂的壁内血肿的情况下。冠状动脉内成像，特别是光学相干断层扫描（OCT）成像，在诊断和治疗方面具有额外价值。我们报告了一名因壁内血肿导致ST段抬高型心肌梗死（STEMI）入院的49岁女性病例。在讨论部分，我们旨在回顾SCAD的流行病学、生理病理学、诊断、治疗及长期预后情况。
