Yang Theodore, Rezkalla Joshua A, Singh Gurpreet
Department of Cardiovascular Disease, Mayo College of Medicine, Rochester, MN, USA.
Eur J Case Rep Intern Med. 2023 Sep 6;10(10):004027. doi: 10.12890/2023_004027. eCollection 2023.
Spontaneous coronary artery dissection (SCAD) is an epicardial coronary artery dissection not associated with atherosclerosis or trauma, and is not iatrogenic. The pathogenesis of SCAD is not fully understood, and the association of coronary artery anomalies and SCAD is not known. We present a case of a 64-year-old woman presenting with non-ST-elevation myocardial infarction (NSTEMI) due to have multivessel SCAD in the setting of anomalous origin of the coronary arteries with all three coronary arteries - right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex artery (LCx) originating from the right sinus of Valsalva.
Spontaneous coronary artery dissection (SCAD) and coronary artery anomaly can arise where all three arteries originate from the right coronary cusp;There are possible associations between SCAD and coronary artery anomalies;Treatment and management of multivessel SCAD with a coronary artery anomaly where all three arteries arise from the right sinus of Valsalva.
自发性冠状动脉夹层（SCAD）是一种不伴有动脉粥样硬化或创伤的心外膜冠状动脉夹层，且非医源性。SCAD的发病机制尚未完全明确，冠状动脉异常与SCAD之间的关联也尚不清楚。我们报告一例64岁女性，因三支冠状动脉（右冠状动脉[RCA]、左前降支动脉[LAD]和左旋支动脉[LCx]）均起源于瓦尔萨尔瓦窦右侧的冠状动脉异常情况下发生多支血管SCAD而出现非ST段抬高型心肌梗死（NSTEMI）。
当所有三支动脉均起源于右冠状动脉瓣叶时，可出现自发性冠状动脉夹层（SCAD）和冠状动脉异常；SCAD与冠状动脉异常之间可能存在关联；对于所有三支动脉均起源于瓦尔萨尔瓦窦右侧的冠状动脉异常情况下的多支血管SCAD的治疗与管理。
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