冠状动脉多发血栓致急性心肌梗死一例  

Acute Myocardial Infarction Caused by Multiple Coronary Thrombosis:a Case Report

作　　者：陈璐 刘心遥[1] 葛兴[1] 陈波[1] 于海荣[1] 路亚枫[1] 郭彩霞 CHEN Lu;LIU Xinyao;GE Xing;CHEN Bo;YU Hairong;LU Yafeng;GUO Caixia(Cardiovascular Center,Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China)

机构地区：[1]首都医科大学附属北京同仁医院心血管中心,北京100176

出　　处：《中国循环杂志》2024年第9期913-916,共4页Chinese Circulation Journal

摘　　要：冠状动脉(冠脉)多发血栓应充分判断血栓来源,鉴别其为血栓形成还是冠脉栓塞。本病例为38岁男性,因胸痛入院,心电图示急性下壁、右心室心肌梗死;急诊冠脉造影示左前降支近中段、第一对角支开口和右冠脉中段见血栓影,未见明显狭窄。术后心电图示急性下壁、右心室、前壁心肌梗死,予强化抗栓等治疗,择期复查冠脉造影并行腔内影像学可见混合斑块及可疑内膜夹层,考虑不稳定斑块及冠脉夹层继发血栓形成可能,予强化药物治疗。患者出院后定期复诊,病情平稳。Multiple thrombosis in the coronary arteries need to be characterized by a thorough determination of the source of the thrombus to distinguish them as thrombosis or coronary embolism.This case was a 38-year-old male patient with chest pain and an electrocardiogram showing acute inferior wall and right ventricular myocardial infarction.Emergency coronary angiography showed thrombosis in the proximal middle of the left anterior descending artery,the opening of the first diagonal artery,and the middle of the right coronary artery,but no obvious stenosis was seen.Postoperative electrocardiogram showed acute inferior wall,right ventricular and anterior wall myocardial infarction,and intensive antithrombotic treatment was applied,elective re-examination of coronary angiography and intraluminal imaging showed mixed plaques and suspicious intimal dissection,indicating the possibility of thrombosis secondary to unstable plaque and coronary dissection,and intensive drug treatment was given.After discharge,the patient was stable during the regular follow-up visits.

关 键 词：冠心病 急性心肌梗死 血栓 血栓形成 

分 类 号：R54[医药卫生—心血管疾病]