A Challenging Case of Extensive Spontaneous Coronary Artery Dissection.

广泛的自发性冠状动脉夹层的挑战性病例。

• 发表时间: Aug 2020
• 来源期刊: JACC Case Rep
• DOI: 10.1016/j.jaccas.2020.07.005
• PMID: 34316991
• 文章类型: Case Reports
• 作者列表: Narula N,Singh H,Krishnan U,Sciria C,Vohra A,Kim J,Lau C,Feldman D,Kim L,Friedman JL

关键词: ACS, acute coronary syndrome; CABG, coronary artery bypass graft; CMR, cardiac magnetic resonance; ECG, electrocardiogram; LAD, left anterior descending artery; LGE, late gadolinium enhancement; LM, left main; MI, myocardial infarction; MINOCA, myocardial infarction with nonobstructive coronary arteries; SCAD, spontaneous coronary artery dissection; TTC, Takotsubo cardiomyopathy; Takotsubo cardiomyopathy; spontaneous coronary artery dissection; women’s health

Abstract

The detection of spontaneous coronary artery dissection (SCAD) causing myocardial infarction is integral in pursuing the appropriate management. Our case posed a diagnostic challenge, with Takotsubo cardiomyopathy and coronary embolism among the potential differential diagnoses upon the initial presentation. Extensive propagation of spontaneous coronary artery dissection subsequently resulted in a significant challenge to management requiring surgical revascularization. (Level of Difficulty: Intermediate.).

摘要

检测引起心肌梗死的自发性冠状动脉夹层（SCAD）是追求适当管理的组成部分。我们的病例提出了诊断挑战,在初次就诊时，Takotsubo心肌病和冠状动脉栓塞是潜在的鉴别诊断。随后，自发性冠状动脉夹层的广泛传播对需要手术血运重建的管理提出了重大挑战。（难度等级：中级。).