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创伤性右冠状动脉夹层作为下壁ST段抬高型心肌梗死的病因

Traumatic Right Coronary Artery Dissection as a Cause of Inferior Wall ST-Elevation Myocardial Infarction.

作者信息

Vyas Vrinda, Badrinath Madhuri, Szombathy Tamas

机构信息

Internal Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

Cardiology, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

出版信息

Cureus. 2020 Jan 18;12(1):e6694. doi: 10.7759/cureus.6694.

Abstract

Blunt cardiac injury, causing coronary artery dissection in the absence of other forms of injury to the heart or lungs is a rare occurrence. Here we present a case of a 41-year-old male who presented with right coronary artery (RCA) dissection after blunt chest trauma. The patient initially presented with chest pain and was diagnosed with an inferior wall myocardial infarction (MI). He then developed a complete heart block and bedside echocardiogram showed right ventricular akinesis. Immediate coronary angiography showed RCA dissection, and TIMI 3 flow was established after the placement of four drug-eluting stents. Blunt trauma-induced RCA dissection is associated with high mortality which needs immediate treatment. Hence through this case report, we would like to stress the importance of having a high index of suspicion for this condition in patients with a blunt chest injury.

摘要

钝性心脏损伤在未伴有心脏或肺部其他形式损伤的情况下导致冠状动脉夹层是一种罕见的情况。在此,我们报告一例41岁男性,其在钝性胸部创伤后出现右冠状动脉(RCA)夹层。患者最初表现为胸痛,被诊断为下壁心肌梗死(MI)。随后出现完全性心脏传导阻滞,床旁超声心动图显示右心室运动减弱。立即进行的冠状动脉造影显示RCA夹层,在置入4枚药物洗脱支架后血流恢复至TIMI 3级。钝性创伤所致的RCA夹层与高死亡率相关,需要立即治疗。因此,通过本病例报告,我们想强调对于钝性胸部损伤患者高度怀疑这种情况的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87a4/7026880/d8f938890242/cureus-0012-00000006694-i01.jpg

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