Nakamoto Kei, Matsuda Morihiro, Kanno Kotaro, Segawa Takatsugu, Nishimoto Orie, Nishiyama Hirohiko, Tamura Ritsu, Kawamoto Toshiharu
Department of Cardiology, National Hospital Organization, Kure Medical Center Chugoku Cancer Center, 3-1 Aoyama-cho, Kure, Hiroshima 737-0023, Japan.
J Cardiol Cases. 2013 Oct 29;8(6):179-182. doi: 10.1016/j.jccase.2013.08.004. eCollection 2013 Dec.
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome, typically affecting young, healthy women, particularly during the peripartum period. Oral contraceptive use is also recognized as a risk factor for SCAD. In the present report, we describe a case of a young woman with an anterior wall myocardial infarction caused by SCAD of the left anterior descending artery (LAD). The event was probably associated with the patient's oral contraceptive use. The patient underwent percutaneous coronary intervention, and she did not experience any recurrent chest pain or other cardiac symptoms. Although the coronary angiography revealed good LAD flow and no symptoms after 6 months, cardiac computed tomography and intravascular ultrasound revealed that LAD dissection was still present. We continued to closely follow-up the patient without initiating any additional intervention, and the patient has had no cardiac event for up to 4 years of follow-up. < We aimed to present a case of spontaneous coronary artery dissection, with a long-term residual dissection. Coronary computed tomography aided the diagnosis of the residual dissection, which was not detected by coronary angiography.>.
自发性冠状动脉夹层(SCAD)是急性冠状动脉综合征的一种罕见病因,通常影响年轻健康女性,尤其是在围产期。口服避孕药的使用也被认为是SCAD的一个危险因素。在本报告中,我们描述了一例年轻女性因左前降支(LAD)的SCAD导致前壁心肌梗死的病例。该事件可能与患者使用口服避孕药有关。患者接受了经皮冠状动脉介入治疗,且未出现任何复发性胸痛或其他心脏症状。尽管冠状动脉造影显示LAD血流良好且6个月后无症状,但心脏计算机断层扫描和血管内超声显示LAD夹层仍然存在。我们继续密切随访该患者,未进行任何额外干预,在长达4年的随访中患者未发生心脏事件。<我们旨在呈现一例伴有长期残余夹层的自发性冠状动脉夹层病例。冠状动脉计算机断层扫描有助于诊断残余夹层,而冠状动脉造影未检测到该夹层。>