Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada.
Catheter Cardiovasc Interv. 2019 Mar 1;93(4):631-634. doi: 10.1002/ccd.27982. Epub 2018 Nov 23.
Spontaneous coronary artery dissection (SCAD) is an important cause of acute coronary syndrome especially in women. The most common underlying predisposing cause of SCAD is fibromuscular dysplasia (FMD), a non-inflammatory arteriopathy that results in weakening of the affected arteries, and can cause dissection or aneurysm. Coronary FMD (CFMD) was described as rare, and was shown to cause SCAD in histopathological case reports. Unfortunately, CFMD is challenging to diagnose on coronary angiography, as the findings can be similar to other causes of coronary artery disease. Therefore, we illustrate two case examples of CFMD on coronary angiography, and highlight findings on optical coherence tomography to aid diagnosis.
自发性冠状动脉夹层(SCAD)是急性冠状动脉综合征的一个重要病因,尤其在女性中较为常见。SCAD 最常见的潜在诱发因素是纤维肌性发育不良(FMD),这是一种非炎症性的血管疾病,可导致受累动脉变薄弱,并引起夹层或动脉瘤。冠状动脉 FMD(CFMD)被认为较为罕见,在组织病理学病例报告中显示可引起 SCAD。不幸的是,CFMD 在冠状动脉造影中难以诊断,因为其表现可能与其他冠状动脉疾病的病因相似。因此,我们展示了冠状动脉造影中 CFMD 的两个病例示例,并强调了光学相干断层扫描(OCT)的发现以辅助诊断。