电邮这篇文章 Spontaneous anterior coronary interventricular artery dissection in a young woman in the late postpartum period: clinical case
- 作者: Anokhina A.R.1,2, Matyushin G.V.1,2, Ustyugov S.A.1,2, Kharkov E.I.2,3, Savchenko E.A.2,3, Vlasov P.N.1, Okhrimchuk V.V.1, Skorobogatov V.V.1, Popova E.V.1, Karaev E.B.3, Tsibulskaya N.Y.2,3, Ryabkov E.I.3
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隶属关系:
- Regional Clinical Hospital
- Voyno-Yasenetsky Krasnoyarsk State Medical University
- Karpovich Krasnoyarsk Interdistrict Clinical Emergency Hospital
- 期: 卷 14, 编号 2 (2023)
- 页面: 115-122
- 栏目: Case reports
- URL: https://journal-vniispk.ru/2221-7185/article/view/146653
- DOI: https://doi.org/10.17816/CS409599
- ID: 146653
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BACKGROUND: Cardiovascular complications during pregnancy and postpartum period are rare but often fatal. The causes and mechanisms of the development of such complications are not fully understood. Spontaneous dissection of the coronary artery against the background of the influence of sex hormones is one of the mechanisms for the development of acute coronary syndrome in the postpartum period. The false lumen of the intramural hematoma overlaps the true lumen, causing arterial obstruction, leading to acute myocardial hypoxia. Thus, awareness that the pathophysiology of spontaneous coronary artery dissection differs from that of acute coronary syndrome associated with atherosclerotic plaque rupture is important, and these patients require different treatment approaches. Currently, an unambiguous and precise strategy for this pathology has not been established, which is why difficulties remain in the management of these patients and choosing treatment strategies.
CLINICAL CASE DESCRIPTION: The article describes a complex clinical case of the development of acute myocardial infarction in the postpartum period in a young woman without risk factors against the background of spontaneous dissection of the coronary artery, complicated by cardiogenic shock, which required emergency percutaneous coronary intervention and stenting of the infarct-dependent artery. The postoperative period proceeded with complications, and extracorporeal membrane oxygenation was required. However, an integrated approach and correctly chosen treatment strategies help stabilize the patient’s condition.
CONCLUSION: Currently, no unambiguous and precise strategy of treatment has been established, so difficulties remain in the management of patients and decision making. In our opinion, an individual patient approach should be followed, taking into account the general state of the organism, type and volume of dissection, consequences and complications, and experience and technical capabilities of the clinic.
作者简介
Alena Anokhina
Regional Clinical Hospital; Voyno-Yasenetsky Krasnoyarsk State Medical University
编辑信件的主要联系方式.
Email: alena.anohina.rus@yandex.ru
ORCID iD: 0000-0001-9528-762X
SPIN 代码: 9055-9403
cardiologist, department assistant
俄罗斯联邦, 3A Partizana Zheleznyaka Str., 660022, Krasnoyarsk; KrasnoyarskGennady Matyushin
Regional Clinical Hospital; Voyno-Yasenetsky Krasnoyarsk State Medical University
Email: matyushin1@yandex.ru
ORCID iD: 0000-0002-0150-6092
SPIN 代码: 2398-1156
MD, Dr. Sci. (Med.), Professor, department head
俄罗斯联邦, 3A Partizana Zheleznyaka Str., 660022, Krasnoyarsk; KrasnoyarskSergei Ustyugov
Regional Clinical Hospital; Voyno-Yasenetsky Krasnoyarsk State Medical University
Email: ustyugoff-s@yandex.ru
ORCID iD: 0000-0003-3105-1946
SPIN 代码: 9045-7075
department head, associate professor
俄罗斯联邦, 3A Partizana Zheleznyaka Str., 660022, Krasnoyarsk; KrasnoyarskEvgeny Kharkov
Voyno-Yasenetsky Krasnoyarsk State Medical University; Karpovich Krasnoyarsk Interdistrict Clinical Emergency Hospital
Email: Harkov-50@mail.ru
ORCID iD: 0000-0002-8208-0926
SPIN 代码: 1234-3885
MD, Dr. Sci. (Med.), department professor
俄罗斯联邦, Krasnoyarsk; KrasnoyarskElena Savchenko
Voyno-Yasenetsky Krasnoyarsk State Medical University; Karpovich Krasnoyarsk Interdistrict Clinical Emergency Hospital
Email: lenasavchenko@rambler.ru
ORCID iD: 0000-0003-4438-1434
SPIN 代码: 2742-2621
MD, Cand. Sci. (Med.), associate professor
俄罗斯联邦, Krasnoyarsk; KrasnoyarskPetr Vlasov
Regional Clinical Hospital
Email: v.petrn@mail.ru
ORCID iD: 0009-0002-3646-3165
anesthesiologist-resuscitator
俄罗斯联邦, 3A Partizana Zheleznyaka Str., 660022, KrasnoyarskVadim Okhrimchuk
Regional Clinical Hospital
Email: vadim_esenin@mail.ru
ORCID iD: 0000-0001-7714-1942
anesthesiologist-resuscitator
俄罗斯联邦, 3A Partizana Zheleznyaka Str., 660022, KrasnoyarskValentin Skorobogatov
Regional Clinical Hospital
Email: vaal_z@list.ru
ORCID iD: 0009-0002-6293-4098
cardiologist
俄罗斯联邦, 3A Partizana Zheleznyaka Str., 660022, KrasnoyarskEkaterina Popova
Regional Clinical Hospital
Email: veffy@mail.ru
ORCID iD: 0009-0004-8940-7612
cardiologist
俄罗斯联邦, 3A Partizana Zheleznyaka Str., 660022, KrasnoyarskElnur Karaev
Karpovich Krasnoyarsk Interdistrict Clinical Emergency Hospital
Email: elnurmed@mail.ru
cardiologist
俄罗斯联邦, KrasnoyarskNatalya Tsibulskaya
Voyno-Yasenetsky Krasnoyarsk State Medical University; Karpovich Krasnoyarsk Interdistrict Clinical Emergency Hospital
Email: solna33@yandex.ru
ORCID iD: 0000-0003-0122-0884
SPIN 代码: 4238-8156
MD, Cand. Sci. (Med.), associate professor
俄罗斯联邦, Krasnoyarsk; KrasnoyarskEvgeny Ryabkov
Karpovich Krasnoyarsk Interdistrict Clinical Emergency Hospital
Email: ryabkov.ei@mail.ru
X-ray surgeon
俄罗斯联邦, Krasnoyarsk参考
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- Vatutin NT, Taradin GG, Bort DV, et al. А cаsе of spontaneous coronary artery dissection (review and case report). The Russian Archives of Internal Medicine. 2019;9(1):23–30. (In Russ). doi: 10.20514/2226-6704-2019-9-1-23-30
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