广泛自发性冠状动脉夹层的不寻常表现：病例报告及文献综述
Unusual presentation of extensive spontaneous coronary dissection: Case report and literature review.
作者信息
França Júlio César Queiroz, Santos Márcio Antonio, Godoy Moacir Fernandes
机构信息
Resident Physician, Department of Cardiology, Hospital de Base, Faculty of Medicine of São José do Rio Preto (FAMERP), São Paulo, Brazil.
Associate Professor, Department of Hemodynamics and Interventional Cardiology, Faculty of Medicine of São José do Rio Preto (FAMERP), São Paulo, Brazil.
出版信息
ARYA Atheroscler. 2017 Jan;13(1):46-49.
BACKGROUND
The etiology of spontaneous dissection of coronary artery (SDCA) is not well understood yet. Different studies have linked this entity to pregnancy, physical stress, collagen diseases and vasculitis. In general, patients do not exhibit the classic risk factors for coronary artery disease, which mandates the suspicion of this condition, especially in young adults with acute coronary syndrome.
CASE REPORT
In this article, we report the case of a 63-year old male patient, asymptomatic, who came for periodic evaluation and after evaluation by exercise and myocardial scintigraphy had high suspicion for severe coronary artery disease and underwent coronary angiography, which showed spontaneous dissection of the left and right branches of the coronary arteries.
CONCLUSION
The choice of therapeutic strategies (clinics, percutaneous or surgical) remains uncertain and should be individualized by the features and form of presentation of the SDCA.
背景
冠状动脉自发夹层（SDCA）的病因尚未完全明确。不同研究已将该病症与妊娠、身体应激、胶原病和血管炎联系起来。一般而言，患者并不表现出冠状动脉疾病的典型危险因素，这就需要怀疑这种病症，尤其是在患有急性冠状动脉综合征的年轻人中。
病例报告
在本文中，我们报告了一名63岁无症状男性患者的病例，该患者前来进行定期评估，经运动和心肌闪烁扫描评估后，高度怀疑患有严重冠状动脉疾病，并接受了冠状动脉造影，结果显示冠状动脉左右分支均有自发夹层。
结论
治疗策略（临床治疗、经皮治疗或手术治疗）的选择仍不确定，应根据SDCA的特征和表现形式进行个体化处理。
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