由于自发冠状动脉解剖而导致的重复性胸痛,通过光学连贯断层扫描诊断
Weimin Wang1,2, Baotao Huang1
1Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
概括
自发冠状动脉解剖 (SCAD) 是心脏病发作的罕见原因,即使在男性中也是如此. 这一案例突出了中年男性的SCAD,在初始血管造影未具结论后,光学连贯性断层扫描 (OCT) 证实了这种情况.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
背景情况:
- 自发冠状动脉解剖 (SCAD) 是急性冠状动脉综合征 (ACS) 的日益公认的原因.
- SCAD通常影响年轻女性,使中年男性的病例变得不那么普遍.
- 及时诊断对于适当的管理和改善患者结果至关重要.
研究的目的:
- 报告中年男性SCAD的一个独特病例.
- 为了说明SCAD的诊断挑战,作为ST段升高心肌梗塞 (STEMI).
- 强调光学连贯断层扫描 (OCT) 在确认SCAD方面的实用性.
主要方法:
- 一个中年男性出现下级STEMI的病例报告.
- 冠状动脉动脉图 (CAG) 最初评估冠状动脉狭窄.
- 光学连贯断层扫描 (OCT) 用于SCAD的最终诊断.
主要成果:
- 最初的CAG仅显示了右冠状动脉 (RCA) 的中度狭窄.
- OCT成像证实了SCAD在RCA中的存在.
- 这名患者被诊断为SCAD诱导的心肌梗塞.
结论:
- SCAD可以发生在中年男性中,并呈现为STEMI.
- CAG可能会低估或错过SCAD,需要先进的成像.
- 当常规血管造影是模两可的时,OCT是诊断SCAD的宝贵工具.
相关概念视频
Coronary Artery Disease III: Clinical Manifestations
325
Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
325
Acute Coronary Syndrome III: Diagnostic Studies
213
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
213
Aneurysm II: Clinical Manifestations and Diagnostic Studies
293
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
293
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
354
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
354
Angina III: Clinical Manifestations and Assessment
200
Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
200
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
389
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
389


