• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

冠状动脉壁内血肿引发的急性冠状动脉综合征

[Acute coronary syndrome provoked by a coronary intramural hematoma].

作者信息

Gutiérrez-Díaz Gonzalo Israel, Buenrostro-Jiménez Arturo David, Rojas-Castillo Roberto, Amador-Avendaño Víctor, Jaime-Zúñiga Alma Yaneth, Zambada-Gamboa Anahí de Jesús, Velázquez-García Manuel Alejandro, Gudiño-Amezcua Diego Armando

机构信息

Instituto Mexicano del Seguro Social, Centro Médico Nacional de Occidente, Hospital de Especialidades "Lic. Ignacio García Téllez", Servicio de Admisión Médica Continua-Urgencias. Guadalajara, Jalisco, México.

Instituto Mexicano del Seguro Social, Centro Médico Nacional de Occidente, Hospital de Especialidades "Lic. Ignacio García Téllez", Servicio de Cardiología. Guadalajara, Jalisco, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2023 May 2;61(3):380-385.

PMID:37216693
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10437236/
Abstract

BACKGROUND

Intramural coronary hematoma (ICH) is an unusual cause of acute coronary syndrome, and it represents a diagnostic challenge, especially in young patients in which it is not considered among the differential causes of acute myocardial ischemia.

CLINICAL CASE

40-year-old female, with type 2 diabetes and no other cardiovascular risk factors, who assisted to the Emergency Room with chest pain. In her first evaluation, electrocardiographic abnormalities, and troponin I elevation were found. A cardiac catheterization was performed, in which a proximal obstruction of the left anterior descending artery was observed, and then an optical coherence tomography (OCT) confirmed the presence of an ICH without a dissection flap. A stent was implanted in the obstruction area, with adequate angiographic outcome. The patient had a satisfactory evolution and was discharged to home without evidence of systolic dysfunction and is free of cardiovascular symptoms at 6-month follow-up.

CONCLUSIONS

ICH must be considered within the differential diagnosis of acute myocardial ischemia in young patients, especially females. Intravascular image diagnosis is essential for the adequate diagnosis and treatment. Treatment must be individualized considering the extent of ischemia.

摘要

背景

壁内冠状动脉血肿（ICH）是急性冠状动脉综合征的一种罕见病因，它构成了诊断挑战，尤其是在年轻患者中，其未被视为急性心肌缺血的鉴别病因之一。

临床病例

一名40岁女性，患有2型糖尿病且无其他心血管危险因素，因胸痛前往急诊室就诊。在首次评估中，发现心电图异常以及肌钙蛋白I升高。进行了心脏导管插入术，术中观察到左前降支近端阻塞，随后光学相干断层扫描（OCT）证实存在无夹层瓣的ICH。在阻塞区域植入了支架，血管造影结果良好。患者病情进展顺利，出院时无收缩功能障碍迹象，在6个月随访时无心血管症状。

结论

在年轻患者，尤其是女性患者的急性心肌缺血鉴别诊断中，必须考虑ICH。血管内图像诊断对于准确诊断和治疗至关重要。治疗必须根据缺血程度个体化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/5dfb919f80c7/04435117-61-3-380-c001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/6d8a7bcdd422/04435117-61-3-380-f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/dc6dc490de1a/04435117-61-3-380-f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/2ca2b4b9849c/04435117-61-3-380-f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/33bc2658bb0a/04435117-61-3-380-f004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/bc7512299f17/04435117-61-3-380-f005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/5dfb919f80c7/04435117-61-3-380-c001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/6d8a7bcdd422/04435117-61-3-380-f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/dc6dc490de1a/04435117-61-3-380-f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/2ca2b4b9849c/04435117-61-3-380-f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/33bc2658bb0a/04435117-61-3-380-f004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/bc7512299f17/04435117-61-3-380-f005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58a4/10437236/5dfb919f80c7/04435117-61-3-380-c001.jpg

相似文献

1
[Acute coronary syndrome provoked by a coronary intramural hematoma].冠状动脉壁内血肿引发的急性冠状动脉综合征
Rev Med Inst Mex Seguro Soc. 2023 May 2;61(3):380-385.
2
Coronary Intramural Hematoma Presenting as Acute Coronary Syndrome.表现为急性冠状动脉综合征的冠状动脉壁内血肿
Intern Med. 2016;55(15):2025-9. doi: 10.2169/internalmedicine.55.6652. Epub 2016 Aug 1.
3
Optical Coherence Tomography Evaluation of Coronary Dissection and Intramural Hematoma.光学相干断层扫描对冠状动脉夹层和壁内血肿的评估
J Invasive Cardiol. 2019 Jan;31(1):E6. doi: 10.25270/jic/19.3101.E6.
4
Postpartum acute coronary syndrome due to intramural hematoma and coronary artery dissection.产后因壁内血肿和冠状动脉夹层导致的急性冠状动脉综合征
Thorac Cardiovasc Surg. 2013 Jan;61(1):85-7. doi: 10.1055/s-0032-1331152. Epub 2012 Nov 16.
5
Myocardial bridging-an unusual cause of Wellens syndrome: A case report.心肌桥——Wellens综合征的罕见病因：一例报告
Medicine (Baltimore). 2020 Oct 9;99(41):e22491. doi: 10.1097/MD.0000000000022491.
6
[Spontaneous coronary artery dissection and ST-segment elevation myocardial infarction (STEMI)].[自发性冠状动脉夹层与ST段抬高型心肌梗死（STEMI）]
Ann Cardiol Angeiol (Paris). 2015 Dec;64(6):467-71. doi: 10.1016/j.ancard.2015.09.054. Epub 2015 Oct 23.
7
Extension of a coronary intramural hematoma after blunt chest trauma.钝性胸部创伤后冠状动脉壁内血肿的扩展
Ulus Travma Acil Cerrahi Derg. 2018 Jan;24(1):78-81. doi: 10.5505/tjtes.2017.72393.
8
Spontaneous coronary artery dissection: Acute findings on coronary computed tomography angiography.自发性冠状动脉夹层：冠状动脉计算机断层成像血管造影的急性表现。
Eur Heart J Acute Cardiovasc Care. 2019 Aug;8(5):467-475. doi: 10.1177/2048872617753799. Epub 2018 Jan 29.
9
Coronary Artery Occlusion Caused by Intramural Hematoma Due to In-Stent Dissection.支架内夹层所致壁内血肿引起的冠状动脉闭塞
JACC Case Rep. 2020 May 20;2(5):707-708. doi: 10.1016/j.jaccas.2020.03.011. eCollection 2020 May.
10
Interventional Dilemma in a Young Woman With Spontaneous Coronary Artery Dissection Who Presented With High-Risk Non-ST-Elevation Myocardial Infarction (NSTEMI) Progressing to ST-Elevation Myocardial Infarction (STEMI).一名年轻女性自发性冠状动脉夹层患者的介入困境，该患者最初表现为高危非ST段抬高型心肌梗死（NSTEMI），随后进展为ST段抬高型心肌梗死（STEMI）。
Cureus. 2022 Apr 9;14(4):e23983. doi: 10.7759/cureus.23983. eCollection 2022 Apr.

本文引用的文献

1
Spontaneous coronary artery dissection: Principles of management.自发性冠状动脉夹层：处理原则。
Cleve Clin J Med. 2021 Nov 2;88(11):623-630. doi: 10.3949/ccjm.88a.20162.
2
An Uncommon Cause of ST-Segment Elevation Myocardial Infarction: Intramural Coronary Artery Hematoma After Blunt Chest Trauma.ST段抬高型心肌梗死的罕见病因：钝性胸部创伤后冠状动脉壁内血肿
JACC Case Rep. 2020 Dec 16;2(15):2304-2309. doi: 10.1016/j.jaccas.2020.09.032. eCollection 2020 Dec.
3
When to use intravascular ultrasound or optical coherence tomography during percutaneous coronary intervention?
在经皮冠状动脉介入治疗期间何时使用血管内超声或光学相干断层扫描？
Cardiovasc Diagn Ther. 2020 Oct;10(5):1429-1444. doi: 10.21037/cdt-20-206.
4
Spontaneous Coronary Artery Dissection: JACC State-of-the-Art Review.自发性冠状动脉夹层：JACC 现状综述。
J Am Coll Cardiol. 2020 Aug 25;76(8):961-984. doi: 10.1016/j.jacc.2020.05.084.
5
Current state-of-play in spontaneous coronary artery dissection.自发性冠状动脉夹层的当前进展情况。
Cardiovasc Diagn Ther. 2019 Jun;9(3):281-298. doi: 10.21037/cdt.2019.04.03.
6
Coronary Intramural Hematoma: Challenges in Diagnosis and Management.冠状动脉壁内血肿：诊断与管理中的挑战
Heart Views. 2019 Jan-Mar;20(1):17-20. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_15_19.
7
Coronary Artery Fenestration: A Promising Technique for Rescue Management of Spontaneous Intramural Hematoma With Luminal Compression.冠状动脉开窗术：一种用于挽救性治疗伴有管腔受压的自发性壁内血肿的有前景的技术。
JACC Cardiovasc Interv. 2018 Sep 24;11(18):1905-1907. doi: 10.1016/j.jcin.2018.06.032.
8
European Society of Cardiology, acute cardiovascular care association, SCAD study group: a position paper on spontaneous coronary artery dissection.欧洲心脏病学会、急性心血管护理协会、自发性冠状动脉夹层研究组：关于自发性冠状动脉夹层的立场文件。
Eur Heart J. 2018 Sep 21;39(36):3353-3368. doi: 10.1093/eurheartj/ehy080.
9
Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association.自发性冠状动脉夹层：科学现状：美国心脏协会的科学声明。
Circulation. 2018 May 8;137(19):e523-e557. doi: 10.1161/CIR.0000000000000564. Epub 2018 Feb 22.
10
Clinical Outcomes Following Intravascular Imaging-Guided Versus Coronary Angiography-Guided Percutaneous Coronary Intervention With Stent Implantation: A Systematic Review and Bayesian Network Meta-Analysis of 31 Studies and 17,882 Patients.血管内影像引导与冠状动脉造影引导经皮冠状动脉介入治疗伴支架植入的临床结局：31 项研究和 17882 例患者的系统评价和贝叶斯网络荟萃分析。
JACC Cardiovasc Interv. 2017 Dec 26;10(24):2488-2498. doi: 10.1016/j.jcin.2017.08.051. Epub 2017 Nov 15.