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心肌桥合并急性心肌梗死

Myocardial Bridge Complicated by Acute Myocardial Infarction.

作者信息

Imnadze Guram G, Kacharava Andro G

机构信息

Department of Cardiology, Schuechtermann Clinic, Bad Rothenfelde, Germany; University Witten/Herdecke, Witten, Germany.

Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA; Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, GA.

出版信息

Rev Cardiovasc Med. 2016;17(3-4):149-153. doi: 10.3909/ricm0843.

Abstract

Typically, myocardial bridging (MB) is considered a relatively benign condition; however, serious complications such as angina pectoris, myocardial infarction (MI), and sudden cardiac death may occur. The diagnosis and appropriate treatment of this pathology are important. We report a case of acute anterior wall ST-elevation MI occurring as a complication of MB involving the mid segment of the left anterior descending artery in a young, otherwise healthy woman who underwent a primary stenting procedure. Pathophysiologic mechanisms underlying the process leading from MB to acute MI vary, and so should the therapy for those patients. Coronary angiography, intravascular ultrasound, and, potentially, optical coherence tomography should be used to assist in establishing an accurate diagnosis in these complex patients and should guide the therapeutic decision in acute settings.

摘要

通常情况下,心肌桥(MB)被认为是一种相对良性的病症;然而,可能会发生诸如心绞痛、心肌梗死(MI)和心源性猝死等严重并发症。对这种病理状况的诊断和恰当治疗很重要。我们报告一例急性前壁ST段抬高型心肌梗死病例,该病例发生于一名年轻、健康的女性,是由累及左前降支中段的心肌桥引发的并发症,该患者接受了急诊支架置入术。从心肌桥发展到急性心肌梗死这一过程的病理生理机制各不相同,这些患者的治疗方法也应有所不同。冠状动脉造影、血管内超声以及可能的光学相干断层扫描应用于协助对这些复杂患者进行准确诊断,并应在急性情况下指导治疗决策。

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