- 期刊
Intracoronary Stenting for Acute Myocardial Infarction Caused by Myocardial Bridging: A Case Report
心肌間橋併發急性心肌梗塞：以血管內支架成功治療之實例
摘要
心肌間橋是一種良性且長期預後相當好的狀態。然而，心肌間橋也可造成一些嚴重的併發症，諸如：心肌梗塞，猝死，或嚴重的心律不整，但是相關的報告卻十分稀少。本文報告一位六十一歲女性，因突發性胸悶併及於背部持續超過六十分鐘來院求診，呼吸困難併些微胸悶，心電圖有陳舊性心肌梗塞，心肌酵素昇高，經心導管檢查得知為冠狀動脈左前降支上，心肌間橋在心臟收縮時呈現90%的動態性阻塞且於舒張期恢復。我們成功的以血管內支架治療，經過六個月追蹤，並無併發症或不適的症狀。在此我們回顧一些文獻，並提出相關於治療心肌間橋之臨床應用及方法。並藉此提醒第一線的醫療人員，即使是像心肌間橋這類良性的疾病，當有嚴重的併發症發生時，侵入性的治療仍是須要的。 血管內支架治療是一種較不擾人、併發症少、易於實行的治療方式，應做為臨開刀的第一選擇。
並列摘要
Myocardial bridging is a benign condition with a favorable long-term outcome. However, some serious complications can be caused by myocardial bridges, such as myocardial infarction, sudden death, or serious arrhythmia, but such reports are rare. We report on a 61-year-old woman who experienced sudden onset of retrosternal chest tightness with radiation to the back lasting over 60 minutes and who came to our hosp ital for help. She had difficulty breathing and chest tightness, and an interoapical infarction on the EKG and elevated cardiac enzymes were found. Cardiac catheterization was performed and revealed myocardial bridging in the left anterior descending coronary artery, resulting in an estimated dynamic stenosis of 90% during systole and complete recovery during diastole. We successfully deployed an intracoronary stent to treat this patient, and she was asymptomatic without complications after 6 months of follow-up. We review the literature and discuss the clinical practice and methods in treating myocardial bridging. We feel we must remind physicians that even benign disease may need invasive intervention when serious complications occur. Intracoronary stenting causes little suffering, has few complications, and is an easy procedure as a first choice before an operation.
延伸閱讀
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