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Hematoma intramural coronario como causa de síndrome coronario agudo

BACKGROUND: : Intramural coronary hematoma (ICH) is an unusual cause of acute coronary syndrome, and it represents a diagnostic challenge, especially in young patients in which it is not considered among the differential causes of acute myocardial ischemia. CLINICAL CASE: 40-year-old female, with ty...

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Autores principales: Gutiérrez-Díaz, Gonzalo Israel, Buenrostro-Jiménez, Arturo David, Rojas-Castillo, Roberto, Amador-Avendaño, Víctor, Jaime-Zúñiga, Alma Yaneth, Zambada-Gamboa, Anahí de Jesús, Velázquez-García, Manuel Alejandro, Gudiño-Amezcua, Diego Armando
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Instituto Mexicano del Seguro Social 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10437236/
https://www.ncbi.nlm.nih.gov/pubmed/37216693
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author Gutiérrez-Díaz, Gonzalo Israel
Buenrostro-Jiménez, Arturo David
Rojas-Castillo, Roberto
Amador-Avendaño, Víctor
Jaime-Zúñiga, Alma Yaneth
Zambada-Gamboa, Anahí de Jesús
Velázquez-García, Manuel Alejandro
Gudiño-Amezcua, Diego Armando
author_facet Gutiérrez-Díaz, Gonzalo Israel
Buenrostro-Jiménez, Arturo David
Rojas-Castillo, Roberto
Amador-Avendaño, Víctor
Jaime-Zúñiga, Alma Yaneth
Zambada-Gamboa, Anahí de Jesús
Velázquez-García, Manuel Alejandro
Gudiño-Amezcua, Diego Armando
author_sort Gutiérrez-Díaz, Gonzalo Israel
collection PubMed
description BACKGROUND: : Intramural coronary hematoma (ICH) is an unusual cause of acute coronary syndrome, and it represents a diagnostic challenge, especially in young patients in which it is not considered among the differential causes of acute myocardial ischemia. CLINICAL CASE: 40-year-old female, with type 2 diabetes and no other cardiovascular risk factors, who assisted to the Emergency Room with chest pain. In her first evaluation, electrocardiographic abnormalities, and troponin I elevation were found. A cardiac catheterization was performed, in which a proximal obstruction of the left anterior descending artery was observed, and then an optical coherence tomography (OCT) confirmed the presence of an ICH without a dissection flap. A stent was implanted in the obstruction area, with adequate angiographic outcome. The patient had a satisfactory evolution and was discharged to home without evidence of systolic dysfunction and is free of cardiovascular symptoms at 6-month follow-up. CONCLUSIONS: ICH must be considered within the differential diagnosis of acute myocardial ischemia in young patients, especially females. Intravascular image diagnosis is essential for the adequate diagnosis and treatment. Treatment must be individualized considering the extent of ischemia.
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spelling pubmed-104372362023-08-19 Hematoma intramural coronario como causa de síndrome coronario agudo Gutiérrez-Díaz, Gonzalo Israel Buenrostro-Jiménez, Arturo David Rojas-Castillo, Roberto Amador-Avendaño, Víctor Jaime-Zúñiga, Alma Yaneth Zambada-Gamboa, Anahí de Jesús Velázquez-García, Manuel Alejandro Gudiño-Amezcua, Diego Armando Rev Med Inst Mex Seguro Soc Casos Clínicos BACKGROUND: : Intramural coronary hematoma (ICH) is an unusual cause of acute coronary syndrome, and it represents a diagnostic challenge, especially in young patients in which it is not considered among the differential causes of acute myocardial ischemia. CLINICAL CASE: 40-year-old female, with type 2 diabetes and no other cardiovascular risk factors, who assisted to the Emergency Room with chest pain. In her first evaluation, electrocardiographic abnormalities, and troponin I elevation were found. A cardiac catheterization was performed, in which a proximal obstruction of the left anterior descending artery was observed, and then an optical coherence tomography (OCT) confirmed the presence of an ICH without a dissection flap. A stent was implanted in the obstruction area, with adequate angiographic outcome. The patient had a satisfactory evolution and was discharged to home without evidence of systolic dysfunction and is free of cardiovascular symptoms at 6-month follow-up. CONCLUSIONS: ICH must be considered within the differential diagnosis of acute myocardial ischemia in young patients, especially females. Intravascular image diagnosis is essential for the adequate diagnosis and treatment. Treatment must be individualized considering the extent of ischemia. Instituto Mexicano del Seguro Social 2023 /pmc/articles/PMC10437236/ /pubmed/37216693 Text en © 2023 Revista Medica del Instituto Mexicano del Seguro Social. https://creativecommons.org/licenses/by-nc-nd/4.0/Esta obra está bajo una Licencia Creative Commons Atribución-NoComercial-SinDerivar 4.0 Internacional.
spellingShingle Casos Clínicos
Gutiérrez-Díaz, Gonzalo Israel
Buenrostro-Jiménez, Arturo David
Rojas-Castillo, Roberto
Amador-Avendaño, Víctor
Jaime-Zúñiga, Alma Yaneth
Zambada-Gamboa, Anahí de Jesús
Velázquez-García, Manuel Alejandro
Gudiño-Amezcua, Diego Armando
Hematoma intramural coronario como causa de síndrome coronario agudo
title Hematoma intramural coronario como causa de síndrome coronario agudo
title_full Hematoma intramural coronario como causa de síndrome coronario agudo
title_fullStr Hematoma intramural coronario como causa de síndrome coronario agudo
title_full_unstemmed Hematoma intramural coronario como causa de síndrome coronario agudo
title_short Hematoma intramural coronario como causa de síndrome coronario agudo
title_sort hematoma intramural coronario como causa de síndrome coronario agudo
topic Casos Clínicos
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10437236/
https://www.ncbi.nlm.nih.gov/pubmed/37216693
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