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献血的一种罕见并发症:心肌梗死伴非阻塞性冠状动脉病变(MINOCA)

A rare complication of blood donation: MINOCA.

作者信息

Şener K, Çolak T, Beydilli I, Çakır A, Yılmaz M, Güneş F, Altuğ E

机构信息

Department of Emergence Medicine, Republic of Turkey, Mersin City Hospital, Mersin, Turkey.

Department of Emergence Medicine, Republic of Turkey, Mersin City Hospital, Mersin, Turkey.

出版信息

Am J Emerg Med. 2025 Feb;88:274.e1-274.e3. doi: 10.1016/j.ajem.2024.12.003. Epub 2024 Dec 7.

Abstract

Blood donation is a life-saving process that involves the temporary loss of a specific blood volume. Although generally safe, it may lead to adverse reactions, particularly in first-time donors. Among these, severe outcomes like myocardial infarction (MI) are extremely rare. Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a distinct clinical entity with various potential etiologies, including coronary vasospasm and sudden hemodynamic changes. This report aims to present a rare case of MINOCA following blood donation to highlight the importance of comprehensive evaluation in blood donors presenting with acute symptoms. A 39-year-old male presented to the emergency department with dizziness and blurred vision following blood donation. Initial assessment revealed normal vital signs, laboratory tests, and no prior medical history. Electrocardiography showed ST-segment elevation in leads D1 and AVL, and ST-segment depression in D3 and AVF. The patient was immediately treated with acetylsalicylic acid and underwent coronary angiography, which revealed normal coronary arteries. The pathological findings on the ECG resolved after the procedure. No changes in troponin levels were observed during intensive care follow-up, and the patient was discharged in good health after two days. MINOCA requires thorough investigation to determine underlying causes. Acute volume loss and sudden intravascular hemoglobin changes were likely contributing factors in this case. Although rare, the association between blood donation and MINOCA highlights the need for vigilance in donors with acute symptoms. Blood donors presenting with dizziness or hypotension should be evaluated comprehensively.

摘要

献血是一个挽救生命的过程,在此过程中会暂时损失一定量的特定血液。尽管通常是安全的,但献血可能会导致不良反应,尤其是在首次献血者中。其中,像心肌梗死(MI)这样的严重后果极为罕见。非阻塞性冠状动脉心肌梗死(MINOCA)是一种具有多种潜在病因的独特临床实体,包括冠状动脉痉挛和突然的血流动力学变化。本报告旨在呈现一例献血后发生MINOCA的罕见病例,以强调对出现急性症状的献血者进行全面评估的重要性。一名39岁男性在献血后因头晕和视力模糊前往急诊科就诊。初始评估显示生命体征、实验室检查正常,且无既往病史。心电图显示D1和AVL导联ST段抬高,D3和AVF导联ST段压低。患者立即接受了阿司匹林治疗并接受了冠状动脉造影,结果显示冠状动脉正常。术后心电图的病理表现得到缓解。在重症监护随访期间未观察到肌钙蛋白水平变化,患者在两天后健康出院。MINOCA需要进行全面调查以确定潜在病因。急性血容量丢失和血管内血红蛋白突然变化可能是该病例的促成因素。尽管罕见,但献血与MINOCA之间的关联凸显了对有急性症状的献血者保持警惕的必要性。出现头晕或低血压的献血者应进行全面评估。

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