创伤性心肌梗死合并冠状动脉瘤样扩张诊治分析

Analysis of diagnosis and treatment of traumatic myocardial infarction with coronary artery aneurysm

1例年轻女性患者胸部受到撞击后出现胸痛、心电图胸前导联ST-T及心肌标志物呈动态变化,胸部CT显示左前降支(LAD)管壁钙化,进一步检查冠状动脉增强CT、血管造影三维重建及心脏彩超发现,LAD瘤样扩张并血栓形成。此病例急性创伤性心肌梗死发生在冠状动脉瘤样扩张的基础上,非常罕见,目前尚缺乏针对此种患者的治疗方案的推荐和证据。在诊治该例患者的过程中,笔者系统回顾了有关创伤性心肌梗死和川崎病冠状动脉疾病的诊治进展,结合该患者的具体临床情况,采取保守治疗策略,取得良好的临床效果。

A young female patient had chest pain after chest knockout,with impact of precordial ST-T dynamic change,myocardial enzyme and troponin rises with wall calcification of LAD in chest image.Further enhanced CT examination of coronary artery angiography 3D reconstruction and echocardiography showed there were LAD aneurysm and thrombosis.The traumatic myocardial infarction of coronary artery aneurysm expansion in this case is very rare,there is still a lack of recommendations and evidence in treatment options for this patient.During the treatment for this patient,the diagnosis and treatment progress in traumatic myocardial infarction and coronary artery diseases of Kawasaki diseases was reviewed,and based on the specific condition of the patient the conservative treatment strategy was adopted and achieved good clinical effect.