Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Provincial Key Lab of Cardiovascular Disease Diagnosis and Treatment, Zhejiang, China.
Department of Medical Examinations, First People's Hospital of Wenling, Zhejiang, China.
J Int Med Res. 2021 Mar;49(3):300060521999525. doi: 10.1177/0300060521999525.
Acute coronary syndrome in the young population is infrequently seen and has a different etiology from that in the elderly population. Giant coronary artery aneurysms are rare and usually asymptomatic, but they can cause acute clinical symptoms such as chest pain or chest tightness. We herein describe a young woman with a history of mitral valve prolapse who developed sudden-onset chest pain. She had mild elevations of her creatine kinase and cardiac troponin levels; however, no ST segment alteration was found on an electrocardiogram, and no abnormal regional wall movement was noted on echocardiography. Cardiac magnetic resonance imaging with late gadolinium enhancement revealed a "mass" at the right coronary artery and linear subendocardial enhancement at the posterior wall. Coronary angiography later confirmed a giant coronary aneurysm with a substantial thrombus. The combined presence of the coronary artery aneurysm and mitral valve prolapse in this patient was likely a sequela of Kawasaki disease.
年轻人中的急性冠状动脉综合征并不常见，其病因与老年人不同。巨大冠状动脉瘤很少见且通常无症状，但可引起胸痛或胸闷等急性临床症状。我们在此描述了一位有二尖瓣脱垂病史的年轻女性，她突发胸痛。她的肌酸激酶和心肌肌钙蛋白水平轻度升高；然而，心电图未见 ST 段改变，超声心动图未见异常节段性壁运动。心脏磁共振成像延迟钆增强显示右冠状动脉有“肿块”，后壁线性心内膜下强化。冠状动脉造影后证实为巨大冠状动脉瘤合并大量血栓。该患者的冠状动脉瘤和二尖瓣脱垂的并存可能是川崎病的后遗症。
