Blackman Alicia, Mohammed Wayne
Department of Anatomical Pathology, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago.
Department of ParaClinical, University of the West Indies at Saint Augustine, Champs Fleurs, Trinidad and Tobago.
BMJ Case Rep. 2018 Mar 20;2018:bcr-2017-222816. doi: 10.1136/bcr-2017-222816.
This case presents a woman in her early 20s who died after the sudden onset of chest pain. Five years earlier, she was investigated for a cardiac murmur during pregnancy and an echocardiogram revealed a 6.0×3.0 cm blood-filled sac compressing the left atrium and anterolateral aspect of the left ventricle with communication to the aortic root. She later had a CT scan of the chest with contrast, which showed aneurysmal dilatation of the left main coronary artery. She was placed on aspirin but defaulted from clinic 11 months post partum. At autopsy, a left coronary aneurysmal sac measuring 10.0×9.0 cm. was identified with a rupture measuring 7.0 cm in length and the pericardial sac contained 900 mL of blood with clots. The cause of death was cardiac tamponade secondary to rupture of the coronary artery aneurysm.
该病例为一名20岁出头的女性，因突发胸痛后死亡。5年前，她在孕期因心脏杂音接受检查，超声心动图显示一个6.0×3.0厘米的充满血液的囊袋，压迫左心房和左心室前外侧，并与主动脉根部相通。后来她接受了胸部增强CT扫描，显示左冠状动脉瘤样扩张。她开始服用阿司匹林，但产后11个月未再到诊所复诊。尸检时，发现一个10.0×9.0厘米的左冠状动脉瘤样囊袋，有一处7.0厘米长的破裂口，心包腔内有900毫升血液及血凝块。死亡原因是冠状动脉瘤破裂继发心脏压塞。
