Dingli Philip, Nombela-Franco Luis, Gonzalo Nieves, Jimenez-Quevedo Pilar, Escaned Javier
Department of Interventional Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC. C/ Prof. Martin Lagos s/n, 28040 Madrid, Spain.
Eur Heart J Case Rep. 2018 Feb 22;2(1):yty022. doi: 10.1093/ehjcr/yty022. eCollection 2018 Mar.
Spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic, non-iatrogenic, non-atherosclerotic separation of the coronary arterial walls, creating a false lumen. The space created is filled with an intramural haematoma (IMH) that compresses the true arterial lumen, decreasing anterograde blood flow. Spontaneous coronary artery dissection is commonly associated with small and medium sized extracoronary vascular abnormalities.
This case report describes a case of SCAD presenting as an acute coronary syndrome together with aortic dilatation requiring aortic valve and aortic root replacement.
Despite the fact that SCAD and aortic dilatation share common aetiologies, this is the first case to our knowledge describing severe aortic dilatation and SCAD presenting concomitantly. This case highlights the importance of confirming the diagnosis of SCAD with intravascular imaging and of investigating for extracoronary arteriopathies.
自发性冠状动脉夹层(SCAD)被定义为冠状动脉壁的非创伤性、非医源性、非动脉粥样硬化性分离,形成假腔。所形成的空间充满壁内血肿(IMH),其压迫真正的动脉腔,减少顺行血流。自发性冠状动脉夹层通常与中小尺寸的冠状动脉外血管异常相关。
本病例报告描述了一例表现为急性冠状动脉综合征并伴有主动脉扩张,需要进行主动脉瓣和主动脉根部置换的SCAD病例。
尽管SCAD和主动脉扩张有共同的病因,但据我们所知,这是首例描述严重主动脉扩张和SCAD同时出现的病例。该病例强调了通过血管内成像确认SCAD诊断以及对冠状动脉外动脉病变进行检查的重要性。