Optical coherence tomography guided treatment avoids stenting in an antiphospholipid syndrome patient:A case report  

作　　者：Bei-Bei Du Xing-Tong Wang Ya-Liang Tong Kun Liu Pei-Pei Li Xiang-Dong Li Ping Yang Ying Wang 

机构地区：[1]Department of Cardiology,The Third Hospital of Jilin University,Jilin Provincial Cardiovascular Research Institute,Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease,Changchun 130031,Jilin Province,China [2]Department of Hematology,The First Hospital of Jilin University,Changchun 130021,Jilin Province,China

出　　处：《World Journal of Clinical Cases》2020年第11期2399-2405,共7页世界临床病例杂志

摘　　要：BACKGROUND Increasing attention has been paid to acute myocardial infarction(AMI)in young female patients for whom secondary factors should be considered during the diagnostic process.Anti-phospholipid syndrome(APS),a rare autoimmune disease that is most common in young female patients,is reportedly related to AMI.To date,coronary interventions,particularly stenting,remains controversial in this special clinical scenario.CASE SUMMARY A 26-year-old female patient was admitted to hospital for acute chest pain,palpitations,and dyspnea.She had a past medical history of APS and pulmonary embolism.Coronary angiography showed acute occlusion of the proximal left anterior descending artery.After repeated thrombus aspirations,residual thrombus and mild stenosis were found in the proximal left anterior descending artery.Optical coherence tomography(OCT)was done,which confirmed the non-atherosclerosis coronary thrombosis and an intact intima in this patient.Deferring or avoiding stenting based on follow-up intracoronary findings with intensified antithrombotic treatment was chosen.One week later,coronary angiography and OCT confirmed an intact intima with no injury and no residual thrombus.The 3-mo telephone follow-up reported a good prognosis.CONCLUSION APS can cause acute non-atherosclerosis coronary thrombosis which presents as an AMI in young female patients.Intracoronary OCT findings can guide interventional strategies in this special clinical scenario.

关 键 词：Anti-phospholipid syndrome Myocardial infarction Optical coherence tomography Coronary intervention Coronary thrombosis Case report 

分 类 号：R593.2[医药卫生—内科学]