Shimada Takenobu, Kadota Kazushige, Kubo Shunsuke, Habara Seiji, Mitsudo Kazuaki
Department of Cardiology, Kurashiki Central Hospital, Japan.
Intern Med. 2016;55(15):2025-9. doi: 10.2169/internalmedicine.55.6652. Epub 2016 Aug 1.
We herein report a case of intramural hematoma without ongoing myocardial ischemia that healed spontaneously with conservative treatment. A 37-year-old woman was admitted due to chest pain. Acute coronary syndrome was diagnosed by electrocardiography and echocardiography. Coronary angiography showed 90% stenosis in the distal portion of the left anterior descending coronary artery, where intravascular ultrasound showed a hematoma, but optical coherence tomography could not detect the entry point. Therefore, we identified the intramural hematoma as the etiology. Because the coronary flow was maintained and chest pain disappeared, we chose conservative treatment. Fifteen days after admission, coronary computed tomography showed an improvement in the intramural hematoma.
我们在此报告一例无持续性心肌缺血的壁内血肿病例，该病例经保守治疗后自发愈合。一名37岁女性因胸痛入院。通过心电图和超声心动图诊断为急性冠状动脉综合征。冠状动脉造影显示左前降支冠状动脉远端有90%的狭窄，血管内超声显示此处有血肿，但光学相干断层扫描未检测到入口点。因此，我们确定壁内血肿为病因。由于冠状动脉血流得以维持且胸痛消失，我们选择了保守治疗。入院15天后，冠状动脉计算机断层扫描显示壁内血肿有所改善。
