Hitomi Yasuhiro, Numasawa Yohei, Yamanaka Shinsuke, Fujita Hiroshi, Fujita Yoko, Tomimatsu Souichi
Department of Cardiology, Self Defense Forces Sendai Hospital, Sendai, Japan.
Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
J Cardiol Cases. 2020 Jun 15;22(4):152-155. doi: 10.1016/j.jccase.2020.05.016. eCollection 2020 Oct.
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction and occurs predominantly in young women without conventional cardiovascular risk factors. Emotional or physical stress and hormone imbalance are associated with the occurrence of SCAD, but the precise mechanisms have not been sufficiently elucidated. Furthermore, there is a paucity of data regarding the underlying disease in patients with SCAD. We herein report a case involving a 48-year-old man who developed acute myocardial infarction due to SCAD in the distal segment of the left anterior descending artery and was successfully treated with conservative medical therapy. A repeat coronary angiography examination performed 2 weeks later revealed complete angiographic healing. In addition, he was treated for suspected Behçet's disease because he had a history of recurrent aphthous stomatitis, nodular erythema, and genital ulcers. After thorough assessment, he was finally diagnosed with vascular Behçet's disease based on additional evidence of bilateral deep vein thrombosis. This case report highlights a rare case of vascular Behçet's disease complicated with SCAD in a male patient. Physicians should be aware that SCAD may occur in association with systemic inflammatory disease including Behçet's disease, even in male patients. < Spontaneous coronary artery dissection (SCAD) is a rare disease entity that can cause acute myocardial infarction especially in young individuals without significant cardiovascular risk factors. We herein describe a 48-year-old man who was diagnosed with vascular Behçet's disease after undergoing conservative medical therapy for acute myocardial infarction due to SCAD. This case report highlights that SCAD may occur in association with systemic inflammatory disease including Behçet's disease, even in male patients.>.
自发性冠状动脉夹层(SCAD)是急性心肌梗死的罕见病因,主要发生在没有传统心血管危险因素的年轻女性中。情绪或身体应激以及激素失衡与SCAD的发生有关,但确切机制尚未得到充分阐明。此外,关于SCAD患者潜在疾病的数据也很匮乏。我们在此报告一例病例,一名48岁男性因左前降支远端的SCAD发生急性心肌梗死,经保守药物治疗成功治愈。2周后进行的重复冠状动脉造影检查显示血管造影完全愈合。此外,由于他有复发性口腔溃疡、结节性红斑和生殖器溃疡病史,曾接受疑似白塞病的治疗。经过全面评估,最终根据双侧深静脉血栓形成的额外证据诊断为血管性白塞病。本病例报告强调了一名男性患者中罕见的血管性白塞病合并SCAD的病例。医生应意识到,即使在男性患者中,SCAD也可能与包括白塞病在内的全身性炎症性疾病相关。<自发性冠状动脉夹层(SCAD)是一种罕见的疾病实体,可导致急性心肌梗死,尤其是在没有明显心血管危险因素的年轻人中。我们在此描述一名48岁男性,他因SCAD导致急性心肌梗死接受保守药物治疗后被诊断为血管性白塞病。本病例报告强调,即使在男性患者中,SCAD也可能与包括白塞病在内的全身性炎症性疾病相关。>