一名患有系统性红斑狼疮的年轻男性因自发性冠状动脉夹层导致急性心肌梗死:病例报告。

IF 2.4 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Yunyi Li, Quan Zhou, Xiao Meng
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引用次数: 0

摘要

系统性红斑狼疮(SLE)是一种自身免疫性疾病,通常发生在年轻女性身上。系统性红斑狼疮患者表现出动脉粥样硬化加速的特征。本研究报告了一例罕见的男性系统性红斑狼疮患者急性心肌梗死(AMI)病例。一名无心血管病史的29岁男性患者被诊断为急性心肌梗死,并接受了冠状动脉造影术,造影显示右冠状动脉(RCA)有一长螺旋形夹层。患者的自身免疫检查结果显示,抗核抗体、抗核糖核蛋白/史密斯抗体和抗斯尤金综合征A抗体均呈阳性。患者被诊断为系统性红斑狼疮,并接受了泼尼松、羟氯喹和碳酸钙治疗。在三个月的随访中,重复冠状动脉造影显示 RCA 没有夹层。血管内超声和光学相干断层扫描也显示 RCA 存在孤立的动脉粥样硬化病变,但没有动脉夹层。据我们所知,这是首例自发性冠状动脉夹层(SCAD)导致心肌梗死的男性系统性红斑狼疮患者。本报告可为今后治疗 SCAD 提供新的思路。对于系统性红斑狼疮和急性心肌梗死患者,尤其是没有心血管风险因素的年轻患者,应考虑SCAD。SCAD的早期诊断对于提供有别于动脉粥样硬化引起的AMI治疗的准确治疗非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Acute myocardial infarction due to spontaneous coronary artery dissection in a young male with systemic lupus erythematosus: A case report.
Systemic lupus erythematosus (SLE) is an autoimmune disease which typically presents in young women. Patients with SLE exhibit features of accelerated atherosclerosis. Here, the present study reported a rare case of acute myocardial infarction (AMI) in a male patient diagnosed with SLE. A 29-year-old male with no cardiovascular history was diagnosed with AMI and underwent coronary angiography, which showed a long-extended spiral-shaped dissection of the right coronary artery (RCA). The patient's autoimmune panel tested positive for antinuclear, anti-nuclear ribonucleoprotein/Smith and anti-Sjogren's syndrome A antibodies. The patient was diagnosed with SLE and was administered prednisone, hydroxychloroquine and calcium carbonate therapy. At the 3-month follow-up, a repeat coronary angiography showed no dissection in the RCA. Intravascular ultrasound and optical coherence tomography also showed an isolated atherosclerotic lesion without arterial dissection in the RCA. To the best of our knowledge, this is the first reported case of a male patient with SLE who developed myocardial infarction caused by spontaneous coronary artery dissection (SCAD). The present report may provide new insights into possible future treatments for SCAD. SCAD should be considered in patients with SLE and AMI, particularly in young patients without cardiovascular risk factors. Early diagnosis of SCAD is important to provide accurate therapy that differs from the treatment of AMI caused by atherosclerosis.
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来源期刊
Experimental and therapeutic medicine
Experimental and therapeutic medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
1.50
自引率
0.00%
发文量
570
审稿时长
1 months
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