- 期刊
- OpenAccess
急性視網膜動脈阻塞症再續發血管攣縮性心肌梗塞
Vasospasm Induced Acute Myocardial Infarction Subsequent to Retinal Artery Occlusion
摘要
目的：報告一例視網膜動脈阻塞，並且於追蹤治療期間續發血管孿縮致心血管疾病發作的病例，以作為臨床上診斷及治療參考。 方法：病例報告 結果：42歲男性，因為右眼急性視力喪失而至本院求治。眼底檢查發現櫻桃紅斑合併視網膜水腫，視網膜動脈狹窄變白。螢光血管攝影檢查發現視網膜動脈的血流延遲出現，脈絡膜的血液灌流也有顯著的延緩，顯示後睫狀動脈同時阻塞。彩色都卜勒超音波檢查證實右眼眼窩之部份後睫狀動脈血流訊號消失，有眼動脈阻塞的可能。患者眼部病發後第7日，又突然感到前胸緊悶疼痛，冒冷汗。在立即服用硝化甘油(NTG)舌下含錠緩解症狀後隨即就醫。心電圖檢查診斷為急性心肌梗塞。心導管檢查確認此例為血管攣縮造成冠狀動脈左前降枝血流阻斷產生的急性心肌梗塞。 結論：建議使用硝化甘油(NTG)舌下含錠，以治療血管攣縮而引發之視網膜動脈或是眼動脈的阻塞。在追蹤期間，硝化甘油(NTG)也可以預防甚至治療可能後續發生的心血管疾病。
關鍵字
無資料並列摘要
A 42-year-old male suffered from acute loss of vision (od) was diagnosed as retinal artery occlusion according to the typical appearance of cherry-red spot. FAG revealed delayed filling of central retinal artery and persistent defect of peripapillary choroidal perfusion. Orbital color Doppler ultrasonography demonstrated decreased flow velocity of central retinal artery and no flow signal of short posterior ciliary artery of right eye. An episode of acute myocardial infarction attacked one week later. EKG revealed anterior wall infarction. Cardiac catheterization demonstrated positive ergonovine test and suggested that this infarction was induced by coronary vasospasm. This case shows the clinical importance of Nitroglycerin (NTG) to treat vasospasm induced acute myocardial infarction and retinal artery occlusion.
延伸閱讀
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