Chien Do Van, Hai Pham Dang, Nhung Le Thi, Son Pham Truong
Department of Cardiology, Military Heart Institute, 108 Central Military Hospital, No. 1 Tran Hung Dao street, Hai Ba Trung District, Hanoi 10000, Vietnam.
Department of Intensive Care Unit, 108 Central Military Hospital, No. 1 Tran Hung Dao street, Hai Ba Trung District, Hanoi 10000, Vietnam.
Eur Heart J Case Rep. 2020 Dec 21;5(1):ytaa427. doi: 10.1093/ehjcr/ytaa427. eCollection 2021 Jan.
Multiple spontaneous coronary artery dissection (SCAD) is a rare condition which may lead to serious consequences such as sudden cardiac death, acute myocardial infarction (AMI), and acute heart failure.
In this paper, we report the case of a 57-year-old woman with acute myelocytic leukaemia who was undergoing her second phase of chemotherapy. After the first induction cycle of intravenous infusion of daunorubicin, the patient experienced chest pain, shortness of breath, and low blood pressure. The electrocardiograms revealed significant ST-elevation in the D1, aVL, and V2-V6 leads, which indicated AMI. Coronary catheterization showed spontaneous coronary dissection in the mid-left descending coronary artery and first obtuse marginal artery of the circumflex. The patient died immediately.
This is the first reported case of multiple SCAD associated with intravenous (IV) daunorubicin infusion. We also reviewed the literature and proposed the mechanism of this complication.
多发性自发性冠状动脉夹层（SCAD）是一种罕见疾病，可能导致严重后果，如心源性猝死、急性心肌梗死（AMI）和急性心力衰竭。
本文报告了一例57岁急性髓细胞白血病女性患者，该患者正在接受第二阶段化疗。在首次静脉输注柔红霉素诱导化疗周期后，患者出现胸痛、呼吸急促和低血压。心电图显示D1、aVL及V2-V6导联ST段显著抬高，提示急性心肌梗死。冠状动脉造影显示左冠状动脉前降支中段及回旋支第一钝缘支自发性冠状动脉夹层。患者随即死亡。
这是首例报道的与静脉输注柔红霉素相关的多发性SCAD病例。我们还回顾了文献并提出了该并发症的发生机制。
