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16 岁女性患者以急性非 ST 段抬高型心肌梗死为首发表现的 Takayasu 动脉炎:病例报告并文献复习。

Acute non-ST segment elevation myocardial infarction as the first manifestation of Takayasu arteritis in a 16-year-old female patient: a case report and literature review.

机构信息

Cardiology Department, Hebei General Hospital, Shijiazhuang, China.

出版信息

J Int Med Res. 2023 Jun;51(6):3000605231178599. doi: 10.1177/03000605231178599.

Abstract

Takayasu arteritis (TA) is now recognized worldwide and is a disease that mainly affects the aorta and its main branches. TA rarely involves the small or medium-sized vessels. Certain vascular lesions, such as arterial stenosis, occlusion, and aneurysm are common with TA. However, patients with new-onset TA who present with left main trunk acute non-ST segment elevation myocardial infarction are extremely rare. We report a 16-year-old female patient with non-ST segment elevation myocardial infarction due to severe stenosis of the left main coronary artery that was caused by TA. She was eventually diagnosed with TA and underwent successful coronary artery stenting combined with glucocorticoids and folate reductase inhibitor therapy. Over the 1-year follow-up, she experienced two episodes of chest pain and was admitted to the hospital. During the second hospitalization, coronary angiography (CAG) revealed 90% stenosis of the original left main trunk (LM) stent. Following percutaneous coronary angiography (PTCA), drug-coated balloon (DCB) angioplasty was performed. Fortunately, a clear diagnosis of TA was made, and treatment was initiated with an interleukin-6 (IL-6) receptor inhibitor. Early diagnosis and therapy for TA are emphasized.

摘要

Takayasu 动脉炎(TA)现在已在全球范围内得到认识,是一种主要影响主动脉及其主要分支的疾病。TA 很少累及小或中等大小的血管。某些血管病变,如动脉狭窄、闭塞和动脉瘤,在 TA 中很常见。然而,新发 TA 患者出现左主干急性非 ST 段抬高型心肌梗死极为罕见。我们报告了一例 16 岁女性患者,因 TA 导致左主干冠状动脉严重狭窄而发生非 ST 段抬高型心肌梗死。她最终被诊断为 TA,并接受了成功的冠状动脉支架置入术联合糖皮质激素和叶酸还原酶抑制剂治疗。在 1 年的随访中,她经历了两次胸痛发作并住院治疗。第二次住院期间,冠状动脉造影(CAG)显示原左主干(LM)支架处狭窄 90%。经皮冠状动脉血管成形术(PTCA)后,行药物涂层球囊(DCB)血管成形术。幸运的是,明确诊断为 TA,并开始使用白细胞介素 6(IL-6)受体抑制剂进行治疗。强调对 TA 的早期诊断和治疗。

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