2023 年第 3 期 第 18 卷

自发性右冠状动脉夹层1例

A case of spontaneous right coronary artery dissection

作者：白嘉琪张闯王翔宇张开威陈光辉

英文作者：Bai Jiaqi Zhang Chuang Wang Xiangyu Zhang Kaiwei Chen Guanghui

单位：中国人民解放军总医院第六医学中心心血管病医学部心内四科，北京100048

英文单位：The Fourth Department of Cardiology Cardiovascular Medical Division the Sixth Medical Center of PLA General Hospital Beijing 100048 China

关键词：自发性冠状动脉夹层；冠状动脉造影；血管内超声；光学相干断层扫描

英文关键词：Spontaneouscoronaryarterydissection;Coronaryangiography;Intravascularultrasound; Opticalcoherencetomography

• 摘要：

• 本文回顾1例年轻女性严重自发性右冠状动脉夹层病例，对近年自发性冠状动脉夹层（SCAD）相关文献进行复习，探讨SCAD的病理机制、临床特征及诊疗经验，为今后的临床工作提供诊治经验、减少漏诊及误诊率、改善患者预后。本例患者入院后予双联抗血小板聚集、控制心率、改善心室重构等治疗，发病1个月后复查冠状动脉造影（CAG）显示病变已自行愈合。SCAD可通过CAG、血管内超声及光学相干断层扫描确诊，药物治疗为首选方案。

• This paper reviews a case of young female with serious spontaneous right coronary artery dissection and associated literatures of spontaneous coronary artery dissection (SCAD), so as to explore the pathological mechanism, clinical characteristics and theraputic experience of SCAD, and to provide diagnosis and treatment experience for future clinical work, reduce the rate of missed diagnosis and misdiagnosis, and improve the prognosis of patients. This patient was treated with dual antiplatelet aggregation, control of heart rate and improvement of ventricular remodeling after admission. Coronary angiography (CAG) showed that the lesions healed spontaneously 1 month after onset. SCAD can be diagnosed by CAG, intravascular ultrasound and optical coherence tomography, and medication is the preferred therapy.