Prizel K R, Hutchins G M, Bulkley B H
Ann Intern Med. 1978 Feb;88(2):155-61. doi: 10.7326/0003-4819-88-2-155.
Although coronary artery embolism is a recognized entity, there is little morphologic information indicating it is a cause of myocardial infarction. We studied patients with coronary artery embolic infarcts, which comprised 13% of our autopsy-studied infarcts. Underlying diseases predisposing to coronary emboli included valvular heart disease (40%), myocardiopathy (29%), coronary atherosclerosis (16%), and chronic atrial fibrillation (24%). Mural thrombi were present in 18 (33%). Myocardial infaction, clinically diagnosed in 15 (27%) patients, caused death in 11 (20%). Most emboli involved the left coronary artery and lodged distally, causing infarcts that were usually transmural. Because of their distal location and recanalization, coronary emboli may be a cause of infarcts with angiographically normal coronaries. Thus, coronary emboli are not rare, may produce signs and symptoms indistinguishable from altherosclerotic coronary disease, and by lodging distally in coronary arteries that are usually previously normal, they most often cause small but transmural myocardial infarction.
尽管冠状动脉栓塞是一个已被认可的病症，但几乎没有形态学信息表明它是心肌梗死的一个病因。我们研究了患有冠状动脉栓塞性梗死的患者，这类患者占我们尸检研究的梗死患者的13%。易引发冠状动脉栓塞的基础疾病包括瓣膜性心脏病（40%）、心肌病（29%）、冠状动脉粥样硬化（16%）和慢性心房颤动（24%）。18例（33%）存在壁血栓。15例（27%）患者临床上诊断为心肌梗死，其中11例（20%）死亡。大多数栓子累及左冠状动脉并栓塞于远端，导致通常为透壁性的梗死。由于其位于远端且再通，冠状动脉栓塞可能是血管造影显示冠状动脉正常的梗死的一个病因。因此，冠状动脉栓塞并不罕见，可能产生与动脉粥样硬化性冠状动脉疾病难以区分的体征和症状，并且通过栓塞于通常先前正常的冠状动脉远端，它们最常导致小的但为透壁性的心肌梗死。
