纤维肌性发育异常患者自发性冠状动脉夹层导致急性心肌梗死的病例报告
Case Report of an Acute Myocardial Infarction as a Result of Spontaneous Coronary Artery Dissection in a Patient with Fibromuscular Dysplasia.
作者信息
Kalinskaya A, Skrypnik D, Kostin A, Vasilieva E, Shpektor A
机构信息
Moscow State University of Medicine and Dentistry Named After A.I. Evdokimov, Clinical Hospital Named After I.V. Davidovsky, Moscow, Russia.
出版信息
Case Rep Cardiol. 2019 May 2;2019:3051616. doi: 10.1155/2019/3051616. eCollection 2019.
BACKGROUND
Spontaneous coronary artery dissection (SCAD) is an underdiagnosed and rare cause of myocardial infarction (MI). SCAD is defined as the separation of the coronary artery wall by hemorrhage with or without intimal tear. It causes acute coronary syndrome in 1.7% to 4% of cases.
CASE SUMMARY
We report a case of a patient with acute MI caused by SCAD with marked progression of dissection within 4 days and spontaneous healing in 2 months. Fibromuscular dysplasia (FMD) of the arteries is an associated condition of SCAD that was found in our patient.
CONCLUSION
In young women admitted to the clinic with signs of acute myocardial infarction, SCAD should be suspected. FMD as an associated condition that should be ruled out in every SCAD patient. Conservative treatment of SCAD is the most preferable strategy.
背景
自发性冠状动脉夹层（SCAD）是心肌梗死（MI）的一种诊断不足且罕见的病因。SCAD被定义为冠状动脉壁因出血而分离，伴或不伴有内膜撕裂。在1.7%至4%的病例中，它会导致急性冠状动脉综合征。
病例摘要
我们报告一例由SCAD引起的急性心肌梗死患者，其夹层在4天内显著进展，2个月内自发愈合。动脉纤维肌发育不良（FMD）是该患者所发现的与SCAD相关的一种病症。
结论
对于因急性心肌梗死症状入院的年轻女性，应怀疑有SCAD。FMD作为一种相关病症，应在每例SCAD患者中予以排除。SCAD的保守治疗是最可取的策略。
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