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一名既往健康的孕妇发生A型主动脉夹层:一个具有挑战性的难题、病例报告及文献综述

Type A Aortic Dissection in a Previously Healthy Pregnant Patient: A Challenging Dilemma, Case Report, and Literature Review.

作者信息

Bateni Elham, Dehghan Maryam, Ahmadikia Zeinab

机构信息

Obstetrics and Gynecology Department, Isfahan University of Medical Sciences, Isfahan, Iran.

Internal Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Case Rep Cardiol. 2024 Dec 26;2024:6971509. doi: 10.1155/cric/6971509. eCollection 2024.

Abstract

Aortic dissection (AoD) is a rare fatal condition in which tearing in the intima causes a false channel in the aorta and can lead to rupture. AoD is classified as the DeBakey classification (Types I, II, III) and Stanford classification (Types A and B). Women with underlying risk factors such as hypertension, smoking, bicuspid aortic valve, and connective tissue disorders are at risk for pregnancy-related AoD. These risk factors may not be recognized until the AoD occurs during pregnancy. We describe an acute incidence of type A AoD in the second trimester of pregnancy. A multiparous woman with no previously known risk factor presented with nonspecific chest pain. She was found to have AoD and underwent successful surgical intervention. This case demonstrates the importance of vigilance in the evaluation of pregnant women with new cardiopulmonary symptoms. A multidisciplinary approach can save the mother and the fetus.

摘要

主动脉夹层(AoD)是一种罕见的致命疾病,内膜撕裂会在主动脉内形成假腔,并可能导致破裂。AoD分为DeBakey分类(I型、II型、III型)和斯坦福分类(A型和B型)。患有高血压、吸烟、二叶式主动脉瓣和结缔组织疾病等潜在危险因素的女性有发生妊娠相关AoD的风险。这些危险因素可能直到妊娠期间发生AoD时才被发现。我们描述了一例妊娠中期急性A型AoD的病例。一名既往无已知危险因素的经产妇出现非特异性胸痛。她被诊断为AoD并接受了成功的手术干预。该病例表明,对出现新的心肺症状的孕妇进行评估时保持警惕非常重要。多学科方法可以挽救母亲和胎儿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0c6/11695080/fac0122d37d0/CRIC2024-6971509.001.jpg

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