血管内超声诊治自发性冠状动脉夹层左前降支闭塞1例及文献复习  

The role of intravascular ultrasound in the management of left anterior descending artery occlusion caused by spontaneous coronary artery dissection:one case report and review of the literature

作　　者：叶晓奇 李齐明 尚云鹏[2] YE Xiaoqi;LI Qiming;SHANG Yunpeng(Department of Cardiology,The Fourth Affiliated Hospital of Zhejiang University School of Medicine,Yiwu,Zhejiang,322000,China;Department of Cardiology,The First Affiliated Hospital of Zhejiang University School of Medicine)

机构地区：[1]浙江大学医学院附属第四医院心血管内科,浙江义乌322000 [2]浙江大学医学院附属第一医院心血管内科

出　　处：《临床心血管病杂志》2018年第8期827-830,共4页Journal of Clinical Cardiology

摘　　要：1病例资料患者,女,54岁。因＂反复胸闷胸痛7d＂入院。7d前行走时突发胸闷,胸骨中下段及左侧心前区胀痛,伴心悸、气促、手足发冷,无大汗、呕吐及晕厥,持续2h未见明显缓解,往当地卫生院就诊,测血压170/98mmHg（1 mmHg=0.133kPa）,予以＂单硝酸异山梨酯注射液＂等输液治疗1h后,胸闷胸痛完全缓解。离院后患者服用＂单硝酸异山梨酯片＂,因头痛难忍自行停药。Spontaneous coronary artery dissection（SCAD）has been reported to be a infrequent cause of acute coronary syndrome and sudden cardiac death.Diagnosis of SCAD is generally made by invasive coronary angiography,with the appearance of a radiolucent intimal flap or slow clearance of contrast from the false lumen.However,coronary angiography is unfortunately an imperfect tool for the diagnosis of SCAD because it is a 2-dimensional luminogram,that does not image the arterial wall.Using angiography alone,the true incidence of SCAD is likely to be underestimated.We present one case of left anterior descending artery occlusion caused by spontaneous coronary artery dissection,with particular reference to the importance of intravascular ultrasound（IVUS）to aid diagnosis and guide subsequent coronary intervention.

关 键 词：急性冠状动脉综合征 自发性冠状动脉夹层 血管内超声 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]