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病例报告：结节性多动脉炎作为大面积心肌梗死的基础疾病

Case report: Polyarteritis nodosa as a substrate for a massive myocardial infarction.

作者信息

Solis-Jimenez Fabio, Gonzalez-Ortiz Araceli, Larios-Lara Juan H, Castro-Garcia Carlos A, Arteaga-Chan Eduardo I, Velazquez-Sanchez Fernando, Vargas-Estrada Jorge L, Ramirez-Marcano Erika Y, Garaygordobil Diego Araiza, Briseño De La Cruz Jose L, Gopar-Nieto Rodrigo, Martinez Daniel Sierra-Lara, Arias-Mendoza Alexandra

机构信息

Cardiology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.

Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.

出版信息

Front Cardiovasc Med. 2023 Jan 12;9:1070378. doi: 10.3389/fcvm.2022.1070378. eCollection 2022.

DOI:10.3389/fcvm.2022.1070378
PMID:36712274
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9877312/
Abstract

This report describes a rare case of a global myocardial infarction caused by severe vasospasm of the coronary arteries secondary to the administration of pyridostigmine in a patient with polyarteritis nodosa (PAN). Details about the clinical presentation, the typical electrocardiographic pattern of multivessel disease, the differential diagnoses suspected in the multi-imaging approach, and the treatment of cardiogenic shock are described. The definitive diagnosis of infarction and the histopathological findings compatible with polyarteritis nodosa were made by autopsy.

摘要

本报告描述了1例罕见病例，结节性多动脉炎（PAN）患者在使用吡啶斯的明后继发冠状动脉严重血管痉挛，导致全层心肌梗死。文中描述了临床表现、多支血管病变的典型心电图模式、多影像学检查中疑似的鉴别诊断以及心源性休克的治疗情况。通过尸检明确了梗死的诊断以及与结节性多动脉炎相符的组织病理学表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d82c/9877312/6c8492cf0e34/fcvm-09-1070378-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d82c/9877312/43d9e40310ab/fcvm-09-1070378-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d82c/9877312/f395dae0c801/fcvm-09-1070378-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d82c/9877312/e658b36aba33/fcvm-09-1070378-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d82c/9877312/6c8492cf0e34/fcvm-09-1070378-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d82c/9877312/43d9e40310ab/fcvm-09-1070378-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d82c/9877312/f395dae0c801/fcvm-09-1070378-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d82c/9877312/e658b36aba33/fcvm-09-1070378-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d82c/9877312/6c8492cf0e34/fcvm-09-1070378-g004.jpg

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本文引用的文献

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Treatment and Outcome of Patients With Coronary Artery Ectasia: Current Evidence and Novel Opportunities for an Old Dilemma.冠状动脉扩张患者的治疗与预后：旧难题的当前证据与新机遇
Front Cardiovasc Med. 2022 Feb 4;8:805727. doi: 10.3389/fcvm.2021.805727. eCollection 2021.
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Characteristics and Outcomes of Coronary Artery Involvement in Polyarteritis Nodosa.多血管炎中冠状动脉受累的特征和结局。
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Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation: Expert Recommendations.非缺血性心肌炎症的心血管磁共振：专家建议。
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