Intravascular Ultrasound-Detected Layered Plaque Mimicking Spontaneous Coronary Artery Dissection.

Hideaki Suwa, Keisuke Yasumura, Samin K Sharma, Annapoorna S Kini
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Abstract

Diagnosing ambiguous culprit lesions by coronary angiography is challenging, particularly in the presence of vessel overlap, tortuosity, or eccentric lesions. In such cases, intravascular imaging provides critical diagnostic insights. We present the case of a 55-year-old female with recurrent chest pain, initially suspected to have spontaneous coronary artery dissection (SCAD) based on clinical context. Coronary angiography was inconclusive; however, intravascular ultrasound (IVUS) revealed distinct plaque layers with varying echogenicity separated by clear borders-findings more consistent with a layered plaque than SCAD. This case highlights the value of intravascular imaging in accurately characterizing ambiguous coronary lesions and guiding appropriate management.

血管内超声检测模拟自发性冠状动脉剥离的层状斑块。
通过冠状动脉造影诊断模棱两可的罪魁祸首病变是具有挑战性的,特别是在存在血管重叠,扭曲或偏心病变的情况下。在这种情况下,血管内成像提供了关键的诊断见解。我们提出的情况下,55岁的女性复发性胸痛,最初怀疑有自发性冠状动脉夹层(SCAD)基于临床背景。冠状动脉造影不确定;然而,血管内超声(IVUS)显示明显的斑块层,不同的回声强度被清晰的边界分开,这些发现比SCAD更符合分层斑块。本病例强调了血管内成像在准确表征模棱两可的冠状动脉病变和指导适当治疗方面的价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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