Postpartum multivessel coronary dissection.

Postpartum multivessel coronary dissection.
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产后多支冠状动脉解剖。

DOI:
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发表时间:
1994
期刊:
The Journal of Heart and Lung Transplantation
影响因子:
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通讯作者:
A. Bove
A. Bove
中科院分区:
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文献类型:
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作者:
P. Mather;C. L. Hansen;B. Goldman;S. Inniss;I. Piña;R. Norris;V. Jeevanandam;A. Bove

文献摘要

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一名29岁的女性在分娩后5天发生急性心肌梗死。连续冠状动脉造影术显示多个进行性冠状动脉夹层,最终累及右冠状动脉和左冠状动脉。持续性心源性休克需要急诊原位心脏移植。心脏切除标本的检查证实存在多发性心肌梗死、冠状动脉夹层和冠状动脉纤维肌肉发育不良。纤维肌肉发育不良合并动脉基质和激素环境的改变可归因于妊娠或分娩,被认为是本病例冠状动脉夹层的可能原因。
A 29-year-old woman had an acute myocardial infarction 5 days after giving birth. Serial coronary angiography showed multiple progressive coronary artery dissections, which eventually involved both the right and left coronary trees. Persistent cardiogenic shock necessitated emergent orthotopic heart transplantation. Examination of the cardiectomy specimen confirmed the presence of multiple myocardial infarctions, coronary artery dissection, and fibromuscular dysplasia of the coronary arteries. Fibromuscular dysplasia combined with changes in the arterial ground substance and hormonal milieu attributable to pregnancy or parturition are proposed as possible causes of coronary artery dissection in this case.