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累及多支冠状动脉和外周动脉的扩展性斯坦福A型主动脉夹层:一例尸检病例报告

Extended Stanford Type-A Aortic Dissection with Multivessel Coronary and Peripheral Artery Involvement: An Autopsy Case Report.

作者信息

Alexandri Maria, Tsellou Maria, Goutas Nikolaos, Galani Konstantina, Papadodima Stavroula

机构信息

Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, 11527 Athens, Greece.

出版信息

Healthcare (Basel). 2023 Jan 29;11(3):386. doi: 10.3390/healthcare11030386.

Abstract

We report the case of a 64-year-old male who died suddenly short after his admission to hospital because of strong chest pain and before any clinical diagnosis was established. His medical history included coronary disease with coronary by-pass surgery at the age of 40 years old, uncontrolled hypertension, diabetes mellitus, and elevated levels of cholesterol. The autopsy revealed quite a rare case of Stanford A aortic dissection with extension to the common and internal carotid arteries; the subclavian, axillary, brachial, and radial arteries; three coronary arteries; the superior mesenteric artery; and the iliac arteries. There was no histological evidence of aortitis or connective tissue disease. The death did not result from the rupture of the aortic dissection, but from myocardial ischemia due to coronary occlusion in combination with hemodynamic disturbance from stress caused by the extended aortic dissection.

摘要

我们报告了一例64岁男性病例,该患者因剧烈胸痛入院后不久突然死亡,且在任何临床诊断确立之前。他的病史包括40岁时接受冠状动脉搭桥手术的冠心病、未控制的高血压、糖尿病以及胆固醇水平升高。尸检显示为一例相当罕见的斯坦福A型主动脉夹层,累及颈总动脉和颈内动脉、锁骨下动脉、腋动脉、肱动脉和桡动脉、三支冠状动脉、肠系膜上动脉以及髂动脉。没有主动脉炎或结缔组织病的组织学证据。死亡并非由主动脉夹层破裂所致,而是由于冠状动脉闭塞导致的心肌缺血,以及扩展的主动脉夹层所引起的应激导致的血流动力学紊乱。

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