自发性冠状动脉夹层的保守治疗：病例报告。
Conservative management of spontaneous coronary artery dissection: a case report.
机构信息
Cardiology B Department of Ibn Sina University Hospital Center, Mohammed V University in Rabat, Rabat, Morocco.
Cardiovascular Surgery A Department of Ibn Sina University Hospital Center, Mohammed V University in Rabat, Rabat, Morocco.
出版信息
Pan Afr Med J. 2020 Aug 25;36:334. doi: 10.11604/pamj.2020.36.334.25546. eCollection 2020.
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndromes (ACS) that mainly occurs in young women with no risk factors and no coronary atherosclerosis. Diagnosis is made by invasive coronary angiography (CA), computed tomography coronary angiography (CTCA), intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The rarity of this entity as well as the complications of invasive treatment make it difficult to choose therapy between conservative management, percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). We report a case of a 36-year-old woman presented with non ST elevation myocardial infarction (NSTEMI) related to spontaneous dissection of coronary arteries (left main trunk, left anterior descending artery and left circumflex artery) treated medically with spectacular results at 2 months, controlled by CTCA.
自发性冠状动脉夹层（SCAD）是急性冠状动脉综合征（ACS）的一个罕见病因，主要发生于无风险因素且无冠状动脉粥样硬化的年轻女性。诊断方法包括有创性冠状动脉造影（CA）、计算机断层冠状动脉造影（CTCA）、血管内超声（IVUS）和光学相干断层扫描（OCT）。由于该疾病较为罕见，且侵袭性治疗会引发并发症，因此在保守治疗、经皮冠状动脉介入治疗（PCI）和冠状动脉旁路移植术（CABG）之间选择治疗方法存在一定难度。我们报告了一例 36 岁女性病例，因自发性冠状动脉夹层（左主干、前降支和左旋支）导致非 ST 段抬高型心肌梗死（NSTEMI），采用药物治疗，2 个月后行 CTCA 检查，结果令人惊喜，病情得到控制。
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