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一名年轻原住民男性冠状动脉扩张伴ST段抬高型心肌梗死:病例报告

Coronary artery ectasia presenting with ST-elevation myocardial infarction in a young indigenous man: a case report.

作者信息

Lee John, Ramkumar Satish, Khav Nancy, Dundon Benjamin K

机构信息

Monash Cardiovascular Research Centre, MonashHeart, Monash Health, 246 Clayton Road, Clayton, Melbourne, VIC 3169, Australia.

出版信息

Eur Heart J Case Rep. 2020 Aug 25;4(5):1-5. doi: 10.1093/ehjcr/ytaa253. eCollection 2020 Oct.

Abstract

BACKGROUND

Coronary artery ectasia (CAE) is often an incidental finding on angiography, however, patients can present with acute coronary syndrome due to a large thrombus burden requiring treatment with percutaneous coronary intervention or with emergency surgery.

CASE SUMMARY

A 26-year-old Indigenous Australian male was admitted with anterior ST-elevation myocardial infarction associated with an out of hospital ventricular fibrillation arrest. Coronary angiography demonstrated thrombotic occlusion of the proximal left anterior descending (LAD) artery with heavy thrombus burden and prominent vascular ectasia of all three coronary arteries. He was managed with surgical thrombectomy and coronary artery bypass graft of his LAD.

DISCUSSION

This is the first case of triple CAE in an Indigenous Australian. The case highlights the lack of consensus approach in the management of CAE due to paucity of prospective studies.

摘要

背景

冠状动脉扩张(CAE)常在血管造影时偶然发现,然而,患者可能因大量血栓负荷而出现急性冠状动脉综合征,需要进行经皮冠状动脉介入治疗或急诊手术。

病例摘要

一名26岁的澳大利亚原住民男性因前壁ST段抬高型心肌梗死伴院外心室颤动骤停入院。冠状动脉造影显示左前降支(LAD)近端血栓性闭塞,血栓负荷重,三支冠状动脉均有明显的血管扩张。他接受了手术血栓切除术及LAD冠状动脉搭桥术。

讨论

这是澳大利亚原住民中首例三重CAE病例。该病例凸显了由于前瞻性研究匮乏,CAE管理缺乏共识性方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1039/7649455/b4a77eb6fd52/ytaa253f1.jpg

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