Liu Ruifang, Xu Fangxing, Zhou Yujie, Shi Dongmei, Liu Tongku
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
The Center of Cardiology, Affiliated Hospital of Beihua University, Jilin, 132011, Jilin, China.
Heliyon. 2023 Jan 20;9(2):e13099. doi: 10.1016/j.heliyon.2023.e13099. eCollection 2023 Feb.
To explore clinical and vascular lesion characteristics of the patients with Takayasu arteritis (TA) manifested firstly as acute myocardial infarction (AMI) at onset and to improve the diagnostic rate of TA.
The clinical and angiographic data of six patients with TA manifested firstly as AMI at onset were retrospectively analyzed.
Of six patients (16-25 years old), 83.33% (five cases) was female, three patients had a history of hypertension and three patients did not have any medical history. One patient had intermittent effort chest tightness. On admission patients all presented with chest pain, dyspnea, hypotension, cardiogenic shock, abnormal electrocardiogram, and elevated cardiac troponin I. The vessel involvement was left coronary main trunk 83.33%, left anterior descending artery 33.33% and left circumflex branch 16.67%, right coronary artery 66.67%, subclavian artery 83.33%, and renal artery 50%. Five patients received the emergency PCI. One patient died of heart failure. During follow-up 3 patients received again PCI treatment.
Clinical and vascular lesion characteristics of those patients were no discomfort before admission, and the suddenly typical manifestation of AMI. Severe stenosis or occlusion occurred in main coronary artery ostia and peripheral large artery. For the TA patients with hemodynamic instability the effectiveness of emergency PCI is positive.
探讨以急性心肌梗死（AMI）为首发表现的大动脉炎（TA）患者的临床及血管病变特点，提高TA的诊断率。
回顾性分析6例以AMI为首发表现的TA患者的临床及血管造影资料。
6例患者年龄16～25岁，83.33%（5例）为女性，3例有高血压病史，3例无任何病史。1例患者有间歇性劳力性胸闷。入院时患者均表现为胸痛、呼吸困难、低血压、心源性休克、心电图异常及心肌肌钙蛋白I升高。血管受累情况为左冠状动脉主干83.33%，左前降支33.33%，左旋支16.67%，右冠状动脉66.67%，锁骨下动脉83.33%，肾动脉50%。5例患者接受了急诊经皮冠状动脉介入治疗（PCI）。1例患者死于心力衰竭。随访期间3例患者再次接受PCI治疗。
这些患者的临床及血管病变特点为入院前无不适，突发典型的AMI表现。主要冠状动脉开口及外周大动脉发生严重狭窄或闭塞。对于血流动力学不稳定的TA患者，急诊PCI疗效肯定。
