Uncommon triple vessel spontaneous coronary artery dissection in the setting of polyarteritis nodosa: a case report.

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL
Nouhaila Lahmouch, Raid Faraj, Soukaina Cherkaoui, Omar Nafii, Mohamed Sarsari, Oualid Kerrouani, Idriss Allalat, Jamila Zarzur, Mohamed Cherti
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引用次数: 0

Abstract

Introduction and importance: Spontaneous coronary artery dissection is a rare cause of acute coronary syndromes not related to atherosclerosis. It involves the sudden tearing of the coronary artery wall, separating the inner intimal lining from the outer vessel wall, typically affecting a single coronary vessel. In 20% of cases, the cause of spontaneous coronary artery dissection is unknown. The other cases often occur in pregnant or postpartum women or in individuals with conditions such as connective tissue disorders or vasculitis.

Case presentation: Here, we describe a case of a 69-year-old African female presenting with non-ST-segment elevation myocardial infarction. Coronary angiography revealed an unusual triple-vessel spontaneous coronary artery dissection affecting peripheral segments, with further investigations suggesting polyarteritis nodosa.

Conclusion: While triple-vessel spontaneous coronary artery dissection and polyarteritis nodosa (PAN) are individually rare, their coexistence is exceptionally uncommon and presents diagnostic and therapeutic challenges. Clinicians should be alert to vasculitic causes in patients with spontaneous coronary artery dissection, especially with atypical clinical features.

结节性多动脉炎引起的罕见三血管自发性冠状动脉夹层:病例报告。
导言和重要性:自发性冠状动脉夹层是急性冠状动脉综合征的一种罕见病因,与动脉粥样硬化无关。它是指冠状动脉壁突然撕裂,内膜与血管外壁分离,通常只影响一根冠状动脉。在 20% 的病例中,自发性冠状动脉夹层的原因不明。其他病例通常发生在孕妇、产后妇女或患有结缔组织病或脉管炎等疾病的人身上:在此,我们描述了一例 69 岁非洲女性非 ST 段抬高型心肌梗死病例。冠状动脉造影显示,患者有不寻常的三血管自发性冠状动脉夹层,并影响到外周节段,进一步检查显示患者患有结节性多动脉炎:结论:虽然三血管自发性冠状动脉夹层和结节性多动脉炎(PAN)各自罕见,但它们同时存在的情况却极为罕见,给诊断和治疗带来了挑战。临床医生应警惕自发性冠状动脉夹层患者的血管炎病因,尤其是不典型的临床特征。
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来源期刊
Journal of Medical Case Reports
Journal of Medical Case Reports Medicine-Medicine (all)
CiteScore
1.50
自引率
0.00%
发文量
436
期刊介绍: JMCR is an open access, peer-reviewed online journal that will consider any original case report that expands the field of general medical knowledge. Reports should show one of the following: 1. Unreported or unusual side effects or adverse interactions involving medications 2. Unexpected or unusual presentations of a disease 3. New associations or variations in disease processes 4. Presentations, diagnoses and/or management of new and emerging diseases 5. An unexpected association between diseases or symptoms 6. An unexpected event in the course of observing or treating a patient 7. Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
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