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年轻患者自发性冠状动脉夹层:病例系列及当前管理算法综述

Spontaneous Coronary Artery Dissection in Young Patients: A Case Series and Review of Current Management Algorithm.

作者信息

Shrestha Dhan B, Shtembari Jurgen, Shehata Kerolus, Gondi Harsha, Munagala Anish, Villegas Santamaria Esteffania, Oli Prakash Raj, Kovacs Daniela, Khosla Sandeep

机构信息

Department of Internal Medicine, Mount Sinai Hospital, Chicago, USA.

Department of Cardiology, Mount Sinai Hospital, Chicago, USA.

出版信息

Cureus. 2023 May 23;15(5):e39393. doi: 10.7759/cureus.39393. eCollection 2023 May.

Abstract

Spontaneous coronary artery dissection (SCAD) is a rare but increasingly recognized non-atherosclerotic cause of acute coronary syndrome. Common risk factors for SCAD are coronary atherosclerosis, female gender, peripartum period, systemic inflammatory conditions, and connective tissue disorders. It manifests as myocardial ischemia and infarction, arrhythmia, and sudden cardiac death. We present a case series of two young men and one young female with SCAD who had chest pain and were diagnosed with SCAD-associated ST-elevation myocardial infarction. Its diagnosis requires a high degree of clinical suspicion and its management is guided by the patient's clinical condition and the characteristics of the lesions.

摘要

自发性冠状动脉夹层(SCAD)是一种罕见但越来越被认识到的急性冠状动脉综合征的非动脉粥样硬化病因。SCAD的常见危险因素包括冠状动脉粥样硬化、女性、围产期、全身炎症性疾病和结缔组织疾病。它表现为心肌缺血和梗死、心律失常以及心源性猝死。我们报告了一组病例,其中两名年轻男性和一名年轻女性患有SCAD,他们出现胸痛并被诊断为与SCAD相关的ST段抬高型心肌梗死。其诊断需要高度的临床怀疑,其治疗以患者的临床状况和病变特征为指导。

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