Department of Cardiology, The People's Hospital of Ya'an, Sichuan, China.
J Int Med Res. 2023 May;51(5):3000605231175635. doi: 10.1177/03000605231175635.
Coronary aneurysms are defined as coronary artery ectasia (CAE) more than 1.5 times the normal adjacent segment diameter or the maximum coronary artery diameter. Although most CAE patients are asymptomatic, some patients present with acute coronary syndrome (ACS), such as angina pectoris, myocardial infarction (MI), and even sudden cardiac death. Sudden death due to coronary artery dilatation is very rare. However, we report a case of a patient with aneurysm-like dilatation of both the left and right coronary arteries, with acute inferior ST segment elevation myocardial infarction and sudden death due to third-degree atrioventricular block. After cardiopulmonary resuscitation, the patient underwent emergency coronary intervention. After thrombus aspiration and intracoronary thrombolysis in the right coronary artery, the atrioventricular block returned to normal on the fifth day of hospitalization. Following anticoagulant therapy, coronary angiography was repeated and showed that the thrombus had disappeared. The patient is recovering well after active rescue at the time of writing.
冠状动脉瘤定义为冠状动脉扩张（CAE）超过正常相邻节段直径的 1.5 倍或最大冠状动脉直径。尽管大多数 CAE 患者无症状，但一些患者表现为急性冠状动脉综合征（ACS），如心绞痛、心肌梗死（MI），甚至心源性猝死。由于冠状动脉扩张导致的猝死非常罕见。然而，我们报告了一例患者的左、右冠状动脉均呈瘤样扩张，伴有急性下壁 ST 段抬高型心肌梗死和三度房室传导阻滞导致的猝死。心肺复苏后，患者接受了紧急冠状动脉介入治疗。在右冠状动脉进行血栓抽吸和冠状动脉内溶栓后，患者于住院第 5 天恢复正常的房室传导。抗凝治疗后，重复冠状动脉造影显示血栓已经消失。在撰写本文时，患者经过积极抢救后恢复良好。
