Buys E M, Suttorp M J, Morshuis W J, Plokker H W
Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
Cathet Cardiovasc Diagn. 1994 Oct;33(2):157-60. doi: 10.1002/ccd.1810330216.
We describe a case of spontaneous coronary artery dissection in a 38-year-old woman presenting with anterior myocardial infarction who was initially treated with thrombolysis. During the administration of thrombolytics the clinical symptoms and the electrocardiogram (ECG) deteriorated. Coronary angiography revealed a major dissection in the proximal left descending coronary artery. A spontaneous dissection was hypothesized to have extended by thrombolytic-induced bleeding into the dissected vessel wall. Therefore, we advocate that, especially in young female patients presenting with an acute myocardial infarction and without cardiac risk factors, direct coronary angiography be considered, rather than thrombolytic therapy, in order to decide for the optimal therapeutic strategy.
我们描述了一例38岁女性自发性冠状动脉夹层病例，该患者表现为前壁心肌梗死，最初接受了溶栓治疗。在溶栓治疗期间，临床症状和心电图（ECG）恶化。冠状动脉造影显示左前降支近端存在严重夹层。推测自发性夹层因溶栓引起的出血扩展至夹层血管壁。因此，我们主张，特别是对于出现急性心肌梗死且无心脏危险因素的年轻女性患者，应考虑直接进行冠状动脉造影，而非溶栓治疗，以便确定最佳治疗策略。
