冠状动脉造影正常的年轻人心肌梗死(附7例报告)

目的观察冠状动脉造影正常年轻人心肌梗死的临床和血管造影特点.方法 1996年1月～2000年3月315例心肌梗死患者中26例血管造影显示冠状动脉完全正常,其中7例年龄<45岁.回顾性分析患者的临床和冠状动脉造影特点.结果 7例患者均为男性,平均年龄41岁.既往均无高血压、糖尿病、高血脂及冠心病家族史,前壁梗死5例,下壁梗死2例.7例患者均有发病前大量吸烟、劳累和紧张等明确诱发因素,其中4例于发病后12小时内入院行静脉溶栓治疗,预后良好,另外3例入院时间超过12小时而行一般药物治疗,出院时留有不同程度心功能不全.结论年轻人心肌梗死可发生在冠状动脉完全正常患者中,一般都有明确诱因,及时入院行溶栓治疗预后良好.

Myocardial infarction in the young with normal coronary arteries

Objective To observe clinical and angiographic features of patients with age <45 year old with normal coronary angiogram Methods From January 1996 to March 2000, 7 patients with age <45 year old and normal coronary arteries in angiogram were recruited from 315 cases with myocardial infarction Retrospective analysis was performed to study the clinical and angiographic features Results All these 7 patients were male with average age of 41 year old None of them had history of hypertension, diabetes mellitus and hyperlipidemia but all were smokers 4 cases were anterior infarction and 3 inferior infarction All these patients had inducement as heavy cigarette smocking and/or strenuous exertional working Among the 7 patients, 4 were admitted to hospital within 12 hours and received thrombolytic treatment with good prognosis, 3 were failed to undergo thrombolytic treatment due to their delaying to admittance and had some extent cardiac insufficiency Conclusion Myocardial infarction might be happened in patients with age <45 year old and normal coronary arteries and most of them had inducement These patients would had good prognosis when admitted earlier with thrombolytic therapy administered