Department of Emergency Medicine; Washington University School of Medicine; St. Louis, MO, USA.
Department of Emergency Medicine; Washington University School of Medicine; St. Louis, MO, USA.
Am J Emerg Med. 2021 Sep;47:319.e1-319.e5. doi: 10.1016/j.ajem.2021.02.041. Epub 2021 Feb 27.
While coronary artery embolism remains an infrequent cause of myocardial infarction (MI), it may present in patients at otherwise low risk for coronary artery disease. When clinicians apply typical risk stratification in these cases, they may be led away from a full evaluation for acute coronary syndrome (ACS). A diagnosis of MI in an otherwise healthy patient should prompt consideration of embolic sources, including Lambl's excrescences (LEs), and echocardiographic evaluation may be necessary to make a final diagnosis. We present a case of LEs in an otherwise healthy 43-year-old male presenting with chest pain and elevated cardiac enzymes, and also review the cases of this rare event found in the literature.
虽然冠状动脉栓塞仍然是心肌梗死 (MI) 的罕见原因，但它可能出现在 otherwise 冠状动脉疾病风险较低的患者中。当临床医生在这些情况下应用典型的风险分层时，他们可能会偏离对急性冠状动脉综合征 (ACS) 的全面评估。在 otherwise 健康的患者中诊断为 MI 应促使考虑栓塞源，包括 Lambl 的赘生物 (LEs)，可能需要进行超声心动图评估以做出最终诊断。我们报告了一例 otherwise 健康的 43 岁男性出现胸痛和心肌酶升高的 LE 病例，并回顾了文献中发现的这种罕见事件的病例。
