Somov Pavel, Marchak Dmitriy, Matusov Arkhip, Viller Alexander, Shevchenko Yuri, Miminoshvili Archili
Pirogov's National Medical Surgical Center, Moscow, Russian Federation.
Institute of Urgent and Recovery Surgery of V.K.Gusak, Ukraine.
Ann Med Surg (Lond). 2019 Jul 11;45:1-5. doi: 10.1016/j.amsu.2019.07.018. eCollection 2019 Sep.
Spontaneous coronary artery dissection is a rare cardiovascular disease that can cause acute myocardial infarction and sudden cardiac death. The mechanism of this pathology and the optimal treatment are not fully understood.
An acute myocardial infarction developed while a fifty five years old woman with a rectal adenocarcinoma was receiving a cisplatin and capecitabine therapy. Coronary angiography demonstrated a multivessel occlusion of coronary arteries.
The authors discuss several factors that may lead to the spontaneous coronary artery dissection including chemotherapy-induced vasospasm. Chemotherapy based on the cisplatin and capecitabine intake can cause a cardiotoxic effect.
Thus, spontaneous coronary artery dissection is a disease with an extremely complex etiololy, which does not have a special treatment guide. Management should be considered individually for each case.
自发性冠状动脉夹层是一种罕见的心血管疾病，可导致急性心肌梗死和心源性猝死。这种病理机制和最佳治疗方法尚未完全明确。
一名55岁患有直肠腺癌的女性在接受顺铂和卡培他滨治疗时发生了急性心肌梗死。冠状动脉造影显示冠状动脉多支血管闭塞。
作者讨论了可能导致自发性冠状动脉夹层的几个因素，包括化疗引起的血管痉挛。基于顺铂和卡培他滨摄入的化疗可产生心脏毒性作用。
因此，自发性冠状动脉夹层是一种病因极其复杂的疾病，没有特殊的治疗指南。应针对每个病例进行个体化管理。
