Marshall William
East Cheshire NHS Trust, Macclesfield, UK.
BMJ Case Rep. 2016 Jun 27;2016:bcr2016216190. doi: 10.1136/bcr-2016-216190.
Coronary artery disease (CAD) in the absence of known cardiovascular risk factors is rare. This is the case report of a 42-year-old white female who was admitted with a non-ST segment elevation myocardial infarction (NSTEMI). The patient had seen her general practitioner (GP) in the 2 weeks prior to this with exertional chest pain. She had no known risk factors for cardiovascular disease and other possible underlying aetiologies were ruled out. The patient underwent percutaneous coronary intervention (PCI) to the culprit lesion in the left anterior descending artery. She was discharged on guideline-directed medical therapy and the Dianette contraceptive pill she was taking was stopped. This case serves to remind us that CAD can occur in a variety of patients including premenopausal females and in the absence of known risk factors. It also emphasises that patients presenting with a convincing history of typical angina require prompt investigations, regardless of their apparent level of risk.
在无已知心血管危险因素的情况下，冠状动脉疾病（CAD）较为罕见。本文报告了一名42岁白人女性，因非ST段抬高型心肌梗死（NSTEMI）入院。该患者在此次发病前2周因劳力性胸痛就诊于全科医生（GP）处。她没有已知的心血管疾病危险因素，其他可能的潜在病因也被排除。患者接受了针对左前降支罪犯病变的经皮冠状动脉介入治疗（PCI）。她出院时接受了指南指导的药物治疗，同时停用了正在服用的黛安拉避孕药。该病例提醒我们，CAD可发生于包括绝经前女性在内的各类患者，且可在无已知危险因素的情况下出现。它还强调，无论患者表面风险水平如何，出现典型心绞痛且病史确凿的患者都需要及时进行检查。
