Onoda Naoki, Izumi Kenichi
Department of Cardiology, Kagawaken Saiseikai Hospital, Kagawa, Japan.
J Cardiol Cases. 2018 Jul 12;18(5):156-159. doi: 10.1016/j.jccase.2018.06.005. eCollection 2018 Nov.
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial ischemia. Identification of intimal flap, true and false lumens in coronary angiogram (CAG) is the standard method to diagnose SCAD. In cases of obscure intimal flap, intravascular ultrasound (IVUS) is a useful method to diagnose, although crossing the wire and IVUS in the dissected lesion is invasive. Multidetector computed tomography (MDCT) provides valuable information in any clinical setting less invasively. We report here a rare case of spontaneous dissecting coronary artery pseudoaneurysm diagnosed by CAG and MDCT, healed by medical treatment, and followed up by MDCT over a 2-year period. < Spontaneous coronary artery dissection (SCAD) is usually diagnosed by the findings of intimal flap, true and false lumens in coronary angiogram (CAG). In case intimal flap is not obvious in CAG, intravascular ultrasound (IVUS) is a useful method to diagnose, although crossing the wire and IVUS in the dissected lesion is invasive. Multidetector computed tomography is an alternative useful method to obtain valuable information to diagnose SCAD less invasively.>.
自发性冠状动脉夹层（SCAD）是急性心肌缺血的一种罕见病因。冠状动脉造影（CAG）中内膜瓣、真腔和假腔的识别是诊断SCAD的标准方法。在内膜瓣不明确的情况下，血管内超声（IVUS）是一种有用的诊断方法，尽管在夹层病变中穿过导丝和进行IVUS检查具有侵入性。多排螺旋计算机断层扫描（MDCT）能在任何临床情况下以较低的侵入性提供有价值的信息。我们在此报告一例罕见的自发性冠状动脉夹层假性动脉瘤病例，通过CAG和MDCT诊断，经药物治疗治愈，并在两年内通过MDCT进行随访。<自发性冠状动脉夹层（SCAD）通常通过冠状动脉造影（CAG）中内膜瓣、真腔和假腔的表现来诊断。如果CAG中内膜瓣不明显，血管内超声（IVUS）是一种有用的诊断方法，尽管在夹层病变中穿过导丝和进行IVUS检查具有侵入性。多排螺旋计算机断层扫描是另一种有用的方法，可通过较低的侵入性获取有价值的信息来诊断SCAD。>
