Katsouras Christos S, Papafaklis Michail I, Lakkas Lampros, Rammos Aidonis, Michalis Lampros K
2nd Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.
J Cardiol Cases. 2021 Sep 21;25(3):182-184. doi: 10.1016/j.jccase.2021.09.003. eCollection 2022 Mar.
Increased homocysteine has been related to the occurrence of dissections in the coronary circulation, aorta, and cervical arteries. Spontaneous coronary artery dissection (SCAD) is a relatively rare phenomenon, and data on the long-term follow-up of patients with SCAD are extremely limited. Herein, we describe a case of a young male patient with 3-vessel SCAD (presence of radiolucent linear defects indicating the presence of dissections in all three major coronary arteries) who was found to have hyperhomocysteinemia and a concurrent methylenetetrahydrofolate reductase prothrombotic mutation. Despite the presence of multi-vessel SCAD, the patient had clinically stable coronary artery disease for a long period. < Three-vessel spontaneous coronary artery dissection (SCAD) is an extremely rare phenomenon. Familiarity with the angiographic characteristics of multi-vessel SCAD as shown here is important for diagnosis. Hyperhomocysteinemia and a concurrent methylenetetrahydrofolate reductase prothrombotic mutation is one of the genetic diseases causally related with premature coronary artery disease and SCAD. Patients with angiographic evidence of SCAD may remain clinically stable for a long time.>.
同型半胱氨酸水平升高与冠状动脉循环、主动脉和颈动脉夹层的发生有关。自发性冠状动脉夹层（SCAD）是一种相对罕见的现象，关于SCAD患者长期随访的数据极其有限。在此，我们描述了一例年轻男性患者，患有三支血管SCAD（存在透光线性缺损，表明所有三支主要冠状动脉均存在夹层），该患者被发现患有高同型半胱氨酸血症，并伴有亚甲基四氢叶酸还原酶促血栓形成突变。尽管存在多支血管SCAD，但该患者长期以来临床冠状动脉疾病病情稳定。<三支血管自发性冠状动脉夹层（SCAD）是一种极其罕见的现象。熟悉此处所示的多支血管SCAD的血管造影特征对诊断很重要。高同型半胱氨酸血症以及同时存在的亚甲基四氢叶酸还原酶促血栓形成突变是与早发性冠状动脉疾病和SCAD有因果关系的遗传性疾病之一。有血管造影证据显示患有SCAD的患者可能长期临床病情稳定。>
