Manari A, Giacometti P, Vergoni W, Mastrangeli S, Guiducci U
II Servizio Di Cardiologia, Arcispedale S. Maria Nuova, Reggio Emilia.
G Ital Cardiol. 1996 Dec;26(12):1437-43.
Myocardial infarction during pregnancy is a rare event and it can be associated both with obstructive coronary artery disease and with functional conditions such as vasospasm. We report a 28-year-old woman without coronary artery disease risk factors, who suffered a Q infarction at 38th week of gestation, complicated by ventricular fibrillation. A healthy child was delivered by cesarean section and the woman made a full recovery. A coronary pseudoaneurysm was detected angiographically, suggesting an initial spontaneous coronary artery dissection followed by ectatic evolution. Coronary dissection associated with coronary vasospasm should be kept into account as etiopathogenetyc mechanisms of acute myocardial infarction.
妊娠期心肌梗死是一种罕见事件,它既可能与阻塞性冠状动脉疾病有关,也可能与诸如血管痉挛等功能性疾病有关。我们报告了一名28岁无冠状动脉疾病危险因素的女性,她在妊娠38周时发生Q波型心肌梗死,并并发心室颤动。通过剖宫产分娩出一个健康的婴儿,该女性完全康复。血管造影检查发现一个冠状动脉假性动脉瘤,提示最初为自发性冠状动脉夹层,随后发展为扩张性病变。冠状动脉夹层合并冠状动脉痉挛应被视为急性心肌梗死的病因学机制。