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1例因左主干闭塞并发主动脉夹层导致的急性心肌梗死，经血管内超声诊断。

A Case of Acute Myocardial Infarction due to Left Main Trunk Occlusion Complicated With Aortic Dissection as Diagnosed by Intravascular Ultrasound.

作者信息

Okamoto Masashi, Amano Tomonori, Matsuoka Shunzo, Hirai Hideki, Masuda Kazunori, Nakajima Kanta, Sueyoshi Atsushi

机构信息

Department of Cardiovascular Medicine, Uji Tokushukai Hospital, 86 Kasugamori, Ogura-cho, Uji-shi, Kyoto 611-0042, Japan.

出版信息

Cardiol Res. 2012 Oct;3(5):232-235. doi: 10.4021/cr212w. Epub 2012 Sep 20.

DOI:10.4021/cr212w
PMID:28348693
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5358137/
Abstract

A 52-year-old man was transferred to our hospital with a sudden onset of severe chest pains. His electrocardiogram revealed ST-segment elevation suggestive of acute myocardial infarction. Emergency coronary angiography showed subtotal occlusion of left main trunk (LMT) with delayed coronary flow. Because intravascular ultrasound revealed a large intimal flap, we diagnosed aortic dissection involving the LMT. After stenting of the LMT, the patient underwent surgical repair of the aortic dissection. Although it is difficult to obtain a correct diagnosis of aortic dissection complicated with myocardial ischemia, we succeeded in diagnosing this rare condition by use of a intravascular ultrasound.

摘要

一名52岁男性因突发严重胸痛被转送至我院。他的心电图显示ST段抬高，提示急性心肌梗死。急诊冠状动脉造影显示左主干（LMT）次全闭塞，冠状动脉血流延迟。因为血管内超声显示有一个大的内膜瓣，我们诊断为累及左主干的主动脉夹层。在对左主干进行支架置入后，患者接受了主动脉夹层的外科修复。虽然很难对合并心肌缺血的主动脉夹层做出正确诊断，但我们通过使用血管内超声成功诊断了这种罕见疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e3/5358137/00f0832e5d64/cr-03-232-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e3/5358137/45180e3b7491/cr-03-232-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e3/5358137/7abfc3559bf7/cr-03-232-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e3/5358137/8aec76598e54/cr-03-232-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e3/5358137/b71ab02f445e/cr-03-232-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e3/5358137/00f0832e5d64/cr-03-232-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e3/5358137/45180e3b7491/cr-03-232-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e3/5358137/7abfc3559bf7/cr-03-232-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e3/5358137/8aec76598e54/cr-03-232-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e3/5358137/b71ab02f445e/cr-03-232-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e3/5358137/00f0832e5d64/cr-03-232-g005.jpg

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本文引用的文献

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Acute myocardial infarction due to left main compression aortic dissection treated by direct stenting.直接支架置入术治疗左主干受压型主动脉夹层所致急性心肌梗死
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Successful treatment in a case of acute aortic dissection complicated with acute myocardial infarction due to occlusion of the left main coronary artery.
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