Kim Daniel Hoan, O'Fee Kevin, Bitter Cindy C
Saint Louis University School of Medicine, Division of Emergency Medicine, St. Louis, MO.
Washington University School of Medicine in St. Louis, Department of Internal Medicine, St. Louis, MO.
J Educ Teach Emerg Med. 2021 Oct 15;6(4):V1-V5. doi: 10.21980/J8F947. eCollection 2021 Oct.
Spontaneous coronary artery dissection is a rare condition that can precipitate acute coronary syndrome in pregnant and peripartum women. A 32-year-old previously healthy female, 2-weeks post-partum, presented to the emergency department after sudden cardiac arrest. Return of spontaneous circulation was achieved after multiple rounds of resuscitation. Electrocardiogram revealed ST elevations in the anterolateral leads with reciprocal changes. She was taken to the catheterization lab by cardiology and was found to have a dissection of the distal left anterior descending coronary artery. The patient was subsequently treated medically with heparin and antiplatelet therapy, but ultimately died of anoxic encephalopathy. The purpose of this report is to describe the risk factors, presentation, and management of spontaneous coronary artery dissection which can be easily overlooked given its rarity.
Spontaneous coronary artery dissection, out-of-hospital cardiac arrest, peri-partum complications.
自发性冠状动脉夹层是一种罕见的病症,可在妊娠和围产期女性中引发急性冠状动脉综合征。一名32岁既往健康的女性,产后2周,在心脏骤停后被送往急诊科。经过多轮复苏后恢复了自主循环。心电图显示前外侧导联ST段抬高并有对应性改变。她被心内科送往导管室,发现左前降支冠状动脉远端夹层。该患者随后接受了肝素和抗血小板治疗,但最终死于缺氧性脑病。本报告的目的是描述自发性冠状动脉夹层的危险因素、临床表现及治疗,鉴于其罕见性,该病很容易被忽视。
自发性冠状动脉夹层、院外心脏骤停、围产期并发症