Bhuiyan Md, Badar Faraz, Ashraf Aqsa, Chryssos Emanuel D, Iftikhar Asma
Internal Medicine, Northwell Health, Mather Hospital, Pleasant Valley, USA.
Internal Medicine, Northwell Health, Port Jefferson, USA.
Cureus. 2022 Sep 3;14(9):e28757. doi: 10.7759/cureus.28757. eCollection 2022 Sep.
We describe a rare case of coronary artery aneurysm (CAA) with recurrent ST-elevation myocardial infarction (STEMI) despite being on standard dual antiplatelet therapy (DAPT). A 47-year-old male presented with chest pain and was found to have inferior wall STEMI along with diffuse right coronary artery (RCA) ectasia and proximal RCA aneurysm, thrombotic occlusion, and dissection. He was managed with extensive thrombectomy, angioplasty, prolonged Heparinization, and DAPT. The patient went on to have a similar presentation nine months later with a recurrent inferior wall STEMI with proximal RCA aneurysm and thrombotic occlusion managed with thrombectomy and bare metal stent placement. He was placed on long-term anticoagulation and DAPT with no further recurrence of MI reported on follow-up.
我们描述了一例罕见的冠状动脉瘤（CAA）病例，尽管患者接受了标准的双联抗血小板治疗（DAPT），仍反复发生ST段抬高型心肌梗死（STEMI）。一名47岁男性因胸痛就诊，被发现患有下壁STEMI，同时伴有右冠状动脉（RCA）弥漫性扩张、RCA近端动脉瘤、血栓性闭塞和夹层。他接受了广泛的血栓切除术、血管成形术、延长肝素化治疗和DAPT。九个月后，患者再次出现类似症状，发生复发性下壁STEMI，伴有RCA近端动脉瘤和血栓性闭塞，接受了血栓切除术和裸金属支架置入术。他接受了长期抗凝和DAPT治疗，随访期间未报告MI再次复发。
