Brás Diogo Rodrigues, Semedo Pedro, Piçarra Bruno Cordeiro, Fernandes Renato
Department of Cardiology, Hospital do Espirito Santo EPE, Evora, Portugal.
Digital Angiography and Interventional Cardiology Unit, Hospital do Espirito Santo EPE, Evora, Portugal.
BMJ Case Rep. 2018 Feb 7;2018:bcr-2017-222828. doi: 10.1136/bcr-2017-222828.
Individuals affected by Prader-Willi syndrome (PWS) may show increased risk for coronary artery disease (CAD), which probably relates, at least, with high burden of cardiovascular risk factors.A 27-year-old man with PWS, obesity, hypertension, diabetes mellitus and dyslipidaemia attended the emergency department with complaints of flu-like condition and chest pain. The ECG revealed a mild ST-segment elevation in inferior leads, followed by positive myocardial necrosis biomarkers. Attending to the high cardiovascular risk profile, ST-segment elevation in inferior territory and wall motion abnormalities, a coronary angiogram was performed. The latter showed a three-vessel CAD, 60% stenosis in midanterior descending artery, total occlusion (100%) of the obtuse marginal artery and 99% stenosis with high thrombi burden in the proximal right coronary artery.The present case report emphasises the plausibility of premature CAD in patients with PWS, a possible underdiagnosed feature of this condition.
患有普拉德-威利综合征（PWS）的个体可能显示出患冠状动脉疾病（CAD）的风险增加，这可能至少与心血管危险因素的高负担有关。一名患有PWS、肥胖、高血压、糖尿病和血脂异常的27岁男性因类似流感症状和胸痛前往急诊科就诊。心电图显示下壁导联轻度ST段抬高，随后心肌坏死生物标志物呈阳性。鉴于其高心血管风险状况、下壁ST段抬高和室壁运动异常，进行了冠状动脉造影。结果显示三支血管CAD，前降支中段狭窄60%，钝缘支完全闭塞（100%），右冠状动脉近端狭窄99%且血栓负荷高。本病例报告强调了PWS患者过早发生CAD的可能性，这可能是该疾病一个可能未被充分诊断的特征。
