Kandolin Riina, Ekström Kaj, Simard Trevor, Hibbert Benjamin, Nery Pablo, Lehtonen Jukka, Kupari Markku, Birnie David
Department of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada.
Division of Cardiology, Heart and Lung Center, Helsinki University Hospital, HUS, Finland.
Oxf Med Case Reports. 2019 May 31;2019(5):omz033. doi: 10.1093/omcr/omz033. eCollection 2019 May.
Cardiac sarcoidosis (CS) is increasingly recognized as a cause of diverse cardiac manifestations. Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome especially among young females. The prevalence of sarcoidosis in the causal spectrum of SCAD has not been described before but sarcoidosis is cited as a potential yet rare cause of SCAD. We aimed to examine the frequency and characteristics of SCAD in CS. Searching two prospective CS registries with 481 CS patients, we found only one case of manifest SCAD. She is a 61-year-old female previously diagnosed with endomyocardial biopsy confirmed CS. She presented with chest pain and elevated troponin. Coronary angiogram revealed two-vessel SCAD. Fluorodeoxyglucose positron emission tomography scan showed likely reactivation of CS. The patient was treated with dual antiplatelet therapy and immunosuppression. Repeat angiogram showed complete resolution of the coronary lesions.
心脏结节病（CS）越来越被认为是多种心脏表现的病因。自发性冠状动脉夹层（SCAD）已成为急性冠状动脉综合征的重要病因，尤其是在年轻女性中。此前尚未描述结节病在SCAD病因谱中的患病率，但结节病被认为是SCAD的一种潜在但罕见的病因。我们旨在研究CS中SCAD的发生率和特征。通过检索两个拥有481例CS患者的前瞻性CS登记库，我们仅发现1例明显的SCAD病例。她是一名61岁女性，之前经心内膜活检确诊为CS。她因胸痛和肌钙蛋白升高就诊。冠状动脉造影显示双支血管SCAD。氟脱氧葡萄糖正电子发射断层扫描显示CS可能复发。该患者接受了双联抗血小板治疗和免疫抑制治疗。重复血管造影显示冠状动脉病变完全消退。
