The Korean Journal of Medicine

  • 제85권5호
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  • Pages.516-520
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  • 2013
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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대동맥 박리에 의한 비정형적 ST분절 상승 심근경색 1예

Atypical Coronary Occlusion in a Patient with ST-Elevation Myocardial Infarction Caused by a Masked Aortic Dissection

  • 박병원 (순천향대학교 의과대학 내과학교실) ;
  • 서대철 (순천향대학교 의과대학 내과학교실) ;
  • 문인기 (순천향대학교 의과대학 내과학교실) ;
  • 정진욱 (순천향대학교 의과대학 내과학교실) ;
  • 방덕원 (순천향대학교 의과대학 내과학교실) ;
  • 현민수 (순천향대학교 의과대학 내과학교실) ;
  • 장원호 (순천향대학교 의과대학 흉부외과학교실)
  • Park, Byoung-Won (Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine) ;
  • Seo, Dae-Chul (Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine) ;
  • Moon, In-Ki (Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine) ;
  • Chung, Jin-Wook (Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine) ;
  • Bang, Duk-Won (Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine) ;
  • Hyon, Min-Su (Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine) ;
  • Chang, Won-Ho (Department of Chest Surgery, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine)
  • 투고 : 2012.11.08
  • 심사 : 2012.12.20
  • 발행 : 2013.11.01
⟨ 이전 논문 다음 논문 ⟩

초록

가슴 통증을 호소한 환자가 심전도에서 ST분절 상승과 비정형적인 관상동맥 폐쇄를 보여 ST분절 상승 심근경색으로 관상동맥 재개통술 시행하였고 이후 퇴원하였으나 가슴통증이 악화되어 재입원하여 대동맥 박리에 의한 심근경색이 진단되었으며 수술적으로 대동맥 박리를 치료한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

ST-elevation myocardial infarction (STEMI) caused by an acute aortic dissection is relatively rare. A diagnosis of dissection can be missed and the situation can become complicated. We report a patient who presented with acute aortic dissection responsible for STEMI related to a dissecting flap into the right coronary artery. This case emphasizes the need for careful assessment of the aorta in cases of atypical coronary occlusion in patients with STEMI without evidence of atherosclerosis in non-culprit coronary segments. The patient was discharged 7 days after primary percutaneous intervention for STEMI. However, she revisited the emergency department for recurrent chest pain and aortic dissection and was diagnosed and managed successfully with surgery.

키워드

참고문헌

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피인용 문헌

  1. STEMI equivalent 심전도 소견을 동반한 근위부 대동맥박리 1예 vol.24, pp.3, 2013, https://doi.org/10.14408/kjems.2020.24.3.141