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钙化栓子导致ST段抬高型心肌梗死:二尖瓣环钙化的一种罕见并发症。

Calcific embolus resulting in ST elevation myocardial infarction: A rare complication of mitral annular calcification.

作者信息

Smith Aaron A H, Wananu Moses K, Bachour Fouad

机构信息

Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA.

Cardiology Division, Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA.

出版信息

J Cardiol Cases. 2019 Sep 21;21(1):5-7. doi: 10.1016/j.jccase.2019.09.002. eCollection 2020 Jan.

Abstract

Coronary embolism is an uncommon mechanism of myocardial infarction in comparison with atherosclerotic plaque rupture. We present a unique case of an anterior ST elevation myocardial infarction as a result of coronary embolism, the source of which appears to be calcific debris from mitral annular calcification (MAC). Although embolic phenomena in the setting of MAC has been documented previously, particularly in the setting of acute ischemic stroke, to our knowledge this is the first reported case in the literature where MAC alone appears to have resulted in a coronary embolic event. < Myocardial infarction as the result of embolic coronary phenomena is uncommon. Thrombotic emboli in the setting of atrial fibrillation, paradoxical emboli in the setting of structural heart defects, and cardiac masses are among the most common causes of coronary embolism. We make the argument that debris from mitral annular calcification may also serve as an uncommon mechanism of embolic phenomena.>.

摘要

与动脉粥样硬化斑块破裂相比,冠状动脉栓塞是心肌梗死的一种不常见机制。我们报告了一例独特的因冠状动脉栓塞导致前壁ST段抬高型心肌梗死的病例,其栓子来源似乎是二尖瓣环钙化(MAC)产生的钙化碎片。尽管之前已有文献记载MAC情况下的栓塞现象,尤其是在急性缺血性卒中的背景下,但据我们所知,这是文献中首次报道仅由MAC导致冠状动脉栓塞事件的病例。<因冠状动脉栓塞现象导致的心肌梗死并不常见。房颤情况下的血栓性栓子、结构性心脏缺陷情况下的反常栓子以及心脏肿物是冠状动脉栓塞最常见的原因。我们认为二尖瓣环钙化产生的碎片也可能是栓塞现象的一种不常见机制。>

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Mitral Annulus Calcification.二尖瓣环钙化。
J Am Coll Cardiol. 2015 Oct 27;66(17):1934-41. doi: 10.1016/j.jacc.2015.08.872.
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Coronary artery embolism and myocardial infarction.冠状动脉栓塞与心肌梗死。
Ann Intern Med. 1978 Feb;88(2):155-61. doi: 10.7326/0003-4819-88-2-155.

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