Takeuchi S, Obayashi T, Toyama J
Department of Cardiology, Kariya General Hospital, Japan.
Heart. 1998 Jan;79(1):96-8. doi: 10.1136/hrt.79.1.96.
A 20 year old man with severe chest pain was hospitalised for acute myocardial infarction. Coronary angiography revealed total obstruction of his right coronary artery, which was successfully recanalised by direct percutaneous transluminal coronary angioplasty (PTCA). There was also diffuse thrombi in the left coronary artery that was not recanalised by perfusion with 3000 U pro-urokinase. Anticoagulant therapy was performed after PTCA. Creatine kinase peaked one day after hospitalisation (4805 U/l). The activated partial thromboplastin time was 62.6 seconds (45%). Plasma anticardiolipin IgG antibodies were high (3.8 and 2.7) in repeated examinations. The PTCA site was patent after three months. Primary antiphospholipid syndrome should be considered as a cause of acute myocardial infarction in young adults, and PTCA with anticoagulant treatment is effective for initial treatment of the syndrome.
一名20岁胸痛严重的男性因急性心肌梗死入院。冠状动脉造影显示其右冠状动脉完全阻塞，通过直接经皮腔内冠状动脉成形术（PTCA）成功再通。左冠状动脉也有弥漫性血栓，用3000 U尿激酶原灌注未能使其再通。PTCA术后进行了抗凝治疗。肌酸激酶在入院一天后达到峰值（4805 U/l）。活化部分凝血活酶时间为62.6秒（45%）。多次检查显示血浆抗心磷脂IgG抗体水平较高（3.8和2.7）。三个月后PTCA部位通畅。原发性抗磷脂综合征应被视为年轻成人急性心肌梗死的一个病因，PTCA联合抗凝治疗对该综合征的初始治疗有效。
