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一名孕妇因自发性冠状动脉夹层导致心肺骤停的病例。

A case of cardiopulmonary arrest due to spontaneous coronary artery dissection in a pregnant woman.

作者信息

Ejima Emiko, Murasato Yoshinobu

机构信息

Division of Cardiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.

出版信息

BMJ Case Rep. 2017 Aug 16;2017:bcr-2017-220119. doi: 10.1136/bcr-2017-220119.

Abstract

We present the case of a young pregnant woman with cardiopulmonary arrest due to acute coronary syndrome. Emergent coronary angiography (CAG) and intravascular ultrasound (IVUS) showed extensive coronary artery dissection in the left anterior descending artery, which was treated with primary percutaneous coronary intervention. After managing the heart failure and disseminated intravascular coagulation, a dead fetus was delivered via caesarean section 4 days after admission to the hospital. Follow-up CAG and IVUS at 18 months showed persistent dissection in the non-stented site; hence, another stent was implanted. Dual antiplatelet therapy was discontinued 6 months later; however, aspirin and beta-blockers were continued lifelong.

摘要

我们报告了一例年轻孕妇因急性冠状动脉综合征发生心肺骤停的病例。急诊冠状动脉造影(CAG)和血管内超声(IVUS)显示左前降支存在广泛冠状动脉夹层,经急诊经皮冠状动脉介入治疗。在处理心力衰竭和弥散性血管内凝血后,入院4天后经剖宫产娩出一死胎。18个月后的随访CAG和IVUS显示,未植入支架部位的夹层持续存在;因此,又植入了一枚支架。6个月后停用双联抗血小板治疗;然而,阿司匹林和β受体阻滞剂终身服用。

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本文引用的文献

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Acute Coronary Syndrome During Pregnancy: A Case Report and Literature Review.孕期急性冠状动脉综合征:一例报告及文献综述
Turk J Emerg Med. 2016 Feb 26;14(3):135-8. doi: 10.5505/1304.7361.2014.05924. eCollection 2014 Sep.
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Perimortem caesarean deliveries.濒死剖宫产
Int J Obstet Anesth. 2016 Aug;27:46-54. doi: 10.1016/j.ijoa.2016.02.008. Epub 2016 Mar 3.

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