Cereda Alberto F, Canova Paolo A, Soriano Francesco S
Cardiovascular Department, Interventional Cardiology, Niguarda Ca' Granda Hospital, Milan, Italy.
J Invasive Cardiol. 2017 Jun;29(6):E67-E68.
We report the case of a myocardial infarction in the post-partum period due to a spontaneous coronary artery dissection. The role of intracoronary imaging was critical: OCT imaging led us to formulate the right diagnosis.OCT imaging revealed a multiple coronary artery dissection in the left main non-detectable on angiography and in the circumflex, with evidence of coronary hematoma in the circumflex and left anterior descending. Beside dissection, OCT showed evidence of a thrombus near the coronary tear in the left main. Our invasive OCT-based strategy proved to be non-harmful and gave an excellent clinical result in the clinical context of a spontaneous multivessel coronary dissection with left main involvement in a rare connective tissue disorder.
我们报告了一例产后因自发性冠状动脉夹层导致心肌梗死的病例。冠状动脉内成像的作用至关重要：光学相干断层扫描（OCT）成像使我们做出了正确诊断。OCT成像显示左主干在血管造影中未检测到夹层，而在回旋支中存在多处冠状动脉夹层，回旋支和左前降支有冠状动脉血肿迹象。除夹层外，OCT显示左主干冠状动脉撕裂处附近有血栓。在一种罕见的结缔组织疾病伴左主干受累的自发性多支冠状动脉夹层临床情况下，我们基于OCT的侵入性策略被证明无害且取得了出色的临床效果。
