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单支冠状动脉患者的自发性冠状动脉夹层

Spontaneous Coronary Artery Dissection in a Patient With a Single Coronary Artery.

作者信息

Al-Shammari Ali, Danial Azmy Habib Steven, Gad Fredy Ramzy Shafik

机构信息

Cardiology, Hampshire Hospitals Foundation Trust, Basingstoke, GBR.

Internal Medicine, Hampshire Hospitals Foundation Trust, Basingstoke, GBR.

出版信息

Cureus. 2024 Oct 16;16(10):e71647. doi: 10.7759/cureus.71647. eCollection 2024 Oct.

Abstract

Spontaneous coronary artery dissection (SCAD) is an uncommon non-atherosclerotic etiology of acute coronary syndrome (ACS) characterized by the formation of a false lumen inside the arterial wall, resulting in sudden occlusion of blood flow without any trauma or intervention. The pathogenesis of SCAD is not completely understood, and the association between coronary artery anomalies and SCAD remains unclear. This case study reports a unique occurrence of non-ST-elevation myocardial infarction (NSTEMI) in a 43-year-old female patient. NSTEMI is caused by spontaneous coronary artery dissection (SCAD) that affects the posterior descending artery (PDA) in the setting of a single coronary artery. This is a very rare subtype of coronary artery anomaly, in which the right coronary artery (RCA) gives rise to the left anterior descending artery (LAD) and left circumflex artery (LCx). The patient was managed conservatively, considering the extent of myocardial involvement and the resolution of symptoms. This congenital anomaly may have been the primary predisposing factor for SCAD development. Further research is required to determine the correlation between coronary artery anomalies and SCAD.

摘要

自发性冠状动脉夹层(SCAD)是急性冠状动脉综合征(ACS)一种罕见的非动脉粥样硬化病因,其特征是动脉壁内形成假腔,导致血流突然阻塞,且无任何外伤或干预。SCAD的发病机制尚未完全明确,冠状动脉异常与SCAD之间的关联仍不清楚。本病例研究报告了一名43岁女性患者发生的罕见非ST段抬高型心肌梗死(NSTEMI)。NSTEMI由自发性冠状动脉夹层(SCAD)引起,该夹层累及单支冠状动脉情况下的后降支动脉(PDA)。这是一种非常罕见的冠状动脉异常亚型,其中右冠状动脉(RCA)发出左前降支动脉(LAD)和左旋支动脉(LCx)。考虑到心肌受累程度和症状缓解情况,对该患者采取了保守治疗。这种先天性异常可能是SCAD发生的主要易感因素。需要进一步研究以确定冠状动脉异常与SCAD之间的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43e1/11567654/bc8d281f9afd/cureus-0016-00000071647-i01.jpg

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