一例罕见的自发性同时多支冠状动脉痉挛导致多部位心肌梗死和心室颤动的病例。
A rare case of spontaneous and simultaneous multivessel coronary artery spasm leading to multisite myocardial infarction and ventricular fibrillation.
作者信息
Iranirad Leili, Sadeghi Mohammad Saleh
机构信息
Assistant Professor, Department of Cardiology, School of Medicine, Qom University of Medical Sciences, Qom, Iran.
Researcher AND General Practitioner, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
出版信息
ARYA Atheroscler. 2018 Jan;14(1):41-43. doi: 10.22122/arya.v14i1.1683.
BACKGROUND
Coronary artery spasm (CAS) can result in life-threatening arrhythmia and sudden cardiac death. Although this disorder has been known for a long time, little is known about it, and its mechanisms have been not identified yet.
CASE REPORT
We describe a 52-year-old woman with no significant cardiovascular risk factors who experienced several episodes of spontaneous and coincident multivessel coronary artery spasm, which led to myocardial infarction as well as malignant arrhythmias. Coronary angiography revealed severe migratory narrowing in the left anterior descending artery and right coronary artery.
CONCLUSION
Simultaneous multivessel coronary artery spasm develop multisite myocardial infarction (MI), and malignant arrhythmias could occur even in the absence of significant stenosis and triggering factors, which would lead to an increased risk of life-threatening cardiac events.
背景
冠状动脉痉挛（CAS）可导致危及生命的心律失常和心源性猝死。尽管这种疾病已为人所知很久，但人们对其了解甚少，其机制尚未明确。
病例报告
我们描述了一名52岁女性，无明显心血管危险因素，经历了数次自发性和同时发生的多支冠状动脉痉挛发作，导致心肌梗死以及恶性心律失常。冠状动脉造影显示左前降支和右冠状动脉严重的游走性狭窄。
结论
同时发生的多支冠状动脉痉挛可导致多部位心肌梗死（MI），即使在无明显狭窄和触发因素的情况下也可能发生恶性心律失常，这会增加危及生命的心脏事件的风险。
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