Qian Jun, Lai Yan, Kuang Li-Jun, Chen Fei, Liu Xue-Bo
Department of Cardiology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
Department of Ultrasound, Luwan Branch, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200065, China.
World J Clin Cases. 2021 May 6;9(13):3095-3101. doi: 10.12998/wjcc.v9.i13.3095.
When autosomal dominant polycystic kidney disease (ADPKD) presents with acute coronary syndrome (ACS), the possibility of spontaneous coronary artery dissection (SCAD) should be highly considered. In some cases, SCAD is considered an extrarenal manifestation of ADPKD depending on the pathological characteristics of the unstable arterial wall in ADPKD.
Here, we report a 46-year-old female patient with ADPKD who presented with ACS. Coronary angiography revealed no definite signs of dissection, while intravascular ultrasound revealed a proximal to distal dissection of the left circumflex. After a careful conservative medication treatment, the patient exhibited favorable prognosis.
In cases of ADPKD co-existing with ACS, differential diagnosis of SCAD should be considered. Moreover, when no clear dissection is found on coronary angiography, IVUS should be performed to prevent missed diagnosis.
当常染色体显性遗传性多囊肾病（ADPKD）并发急性冠脉综合征（ACS）时，应高度考虑自发性冠状动脉夹层（SCAD）的可能性。在某些情况下，根据ADPKD中不稳定动脉壁的病理特征，SCAD被认为是ADPKD的肾外表现。
在此，我们报告一名46岁患有ADPKD的女性患者，其出现了ACS。冠状动脉造影未发现明确的夹层征象，而血管内超声显示左旋支从近端到远端的夹层。经过仔细的保守药物治疗，患者预后良好。
在ADPKD合并ACS的病例中，应考虑SCAD的鉴别诊断。此外，当冠状动脉造影未发现明确的夹层时，应进行血管内超声检查以防止漏诊。
