产后自发性冠状动脉、椎动脉和肠系膜动脉夹层：一例报告
Postpartum spontaneous coronary, vertebral, and mesenteric artery dissections: a case report.
作者信息
Spence Sean, Sud Maneesh, Bajaj Ravi, Zavodni Anna, Sandhu Sharron, Madan Mina
机构信息
Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room D3 80, Toronto, Ontario, M4N 3M5, Canada.
出版信息
J Med Case Rep. 2016 Jun 8;10:153. doi: 10.1186/s13256-016-0937-0.
BACKGROUND
Spontaneous coronary artery dissection is a rare cause of myocardial infarction that must always be considered on a clinician's differential diagnosis, particularly in patients <50-years old with a paucity of typical vascular risk factors.
CASE PRESENTATION
We describe a case of a 33-year-old white woman, 3 weeks postpartum, presenting with retrosternal chest and back pain, neck pain and stiffness, and intermittent headaches. Subsequent workup revealed concurrent spontaneous dissections in three separate medium-sized arterial beds.
CONCLUSIONS
She was successfully managed in a conservative fashion, highlighting that percutaneous or surgical revascularization can often be foregone in favor of conservative medical therapy.
背景
自发性冠状动脉夹层是心肌梗死的一种罕见病因，临床医生在鉴别诊断时必须始终予以考虑，尤其是对于年龄小于50岁且典型血管危险因素较少的患者。
病例介绍
我们描述了一例33岁的白人女性病例，产后3周，出现胸骨后胸痛、背痛、颈部疼痛和僵硬以及间歇性头痛。随后的检查发现三个不同的中等大小动脉床同时发生自发性夹层。
结论
她通过保守治疗成功治愈，这突出表明在很多情况下可以放弃经皮或手术血运重建，而选择保守药物治疗。
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