Chu Hongshuo, Gao Ting, Li Yang, Zhong Peng, Zhang Hongli, Feng Chuanming, Wei Zixiu
Department of Cardiology, Jining Key Laboratory of Metabolic Cardiovascular Diseases, Institute of Cardiovascular Diseases of Jining Medical Research Academy, Jining No. 1 People's Hospital, Jining, Shandong, China.
Department of Rehabilitation Medicine, Jining No. 1 People's Hospital, Jining, Shandong, China.
Medicine (Baltimore). 2025 Sep 5;104(36):e44328. doi: 10.1097/MD.0000000000044328.
Myocardial infarction with nonobstructive coronary arteries (MINOCA) has diverse ischemic etiologies and has been defined by the absence of angiographically significant obstructive coronary artery disease. Blood transfusion has seldom been reported as a precipitating factor for MINOCA. Here, we present a rare case of transfusion-associated MINOCA in a young woman without underlying chronic conditions, aiming to raise clinical awareness of this uncommon yet important phenomenon and to explore its potential pathophysiological mechanisms.
A 30-year-old woman with acute anemia secondary to abnormal uterine hemorrhage developed MINOCA and cardiogenic shock following blood transfusion.
Abnormal uterine hemorrhage, anemia, MINOCA, cardiogenic shock.
The patient received hemocoagulase and oxytocin to control vaginal bleeding. Anemia was managed with a total transfusion of 6 units of erythrocytes. Coronary angiography was performed promptly after the diagnosis of acute coronary syndrome. Vasopressin was administered to manage cardiogenic shock. Clopidogrel, ticagrelor, nicorandil, and rosuvastatin were prescribed to promote the recovery of coronary microvascular function.
Electrocardiographic changes resolved within hours, and left ventricular ejection fraction improved from 44% to 66% by 1 month. The patient completed a 6-minute walk test without symptoms and remained stable, with resolution of anemia and full cardiac recovery.
The delicate balance between hemorrhage and hemostasis was emphasized. Treatment strategies for blood transfusion-induced MINOCA remain limited, and our therapeutic approach may provide an effective option for clinical practice.
非阻塞性冠状动脉心肌梗死（MINOCA）具有多种缺血病因，其定义为血管造影显示无显著阻塞性冠状动脉疾病。输血很少被报道为MINOCA的诱发因素。在此，我们报告一例年轻女性在无基础慢性病情况下发生的输血相关MINOCA罕见病例，旨在提高对这一罕见但重要现象的临床认识，并探讨其潜在的病理生理机制。
一名30岁女性因子宫异常出血继发急性贫血，输血后发生MINOCA和心源性休克。
子宫异常出血、贫血、MINOCA、心源性休克。
患者接受了血凝酶和缩宫素以控制阴道出血。通过总共输注6单位红细胞来治疗贫血。在诊断为急性冠状动脉综合征后立即进行冠状动脉造影。给予血管加压素治疗心源性休克。处方氯吡格雷、替格瑞洛、尼可地尔和瑞舒伐他汀以促进冠状动脉微血管功能恢复。
心电图改变在数小时内消失，左心室射血分数在1个月内从44%提高到66%。患者完成6分钟步行试验且无症状，病情保持稳定，贫血得到缓解，心脏完全恢复。
强调了出血与止血之间的微妙平衡。输血诱导的MINOCA的治疗策略仍然有限，我们的治疗方法可能为临床实践提供一种有效的选择。
