Wilson Christopher J, Melnychuk Eric, Bernett John
Geisinger Commonwealth School of Medicine, Geisinger Medical Center, Department of Emergency Medicine, Danville, Pennsylvania.
Geisinger Commonwealth School of Medicine, Geisinger Wyoming Valley, Department of Emergency Medicine, Danville, Pennsylvania.
Clin Pract Cases Emerg Med. 2019 Oct 14;3(4):395-397. doi: 10.5811/cpcem.2019.9.43762. eCollection 2019 Nov.
This is a case of the most severe and potentially fatal complication of coronary artery vasospasm. We report a case of a 40-year-old female presenting to the emergency department (ED) via emergency medical services with chest pain. The patient experienced a ventricular fibrillation cardiac arrest while in the ED. Post-defibrillation electrocardiogram showed changes suggestive of an ST-elevation myocardial infarction (STEMI). Cardiac catheterization showed severe left anterior descending spasm with no evidence of disease. Coronary vasospasm is a consideration in the differential causes of ventricular fibrillation and STEMI seen in the ED.
这是一例冠状动脉血管痉挛最严重且可能致命的并发症。我们报告一例40岁女性患者,通过紧急医疗服务被送往急诊科,主诉胸痛。该患者在急诊科时发生心室颤动心脏骤停。除颤后的心电图显示有提示ST段抬高型心肌梗死(STEMI)的变化。心脏导管检查显示左前降支严重痉挛,无疾病证据。冠状动脉血管痉挛是急诊科所见心室颤动和STEMI鉴别诊断原因之一。