Disección coronaria espontánea en paciente fumador

  • Juan Carlos Juez N.
  • Gustavo Adolfo García Lozada

Resumen

La disección coronaria (DC) es la division de las capas que conforman la arteria coronaria, tiene una incidencia de 0.07% a 1.1% en cateterismo cardíaco,  siendo más frecuente en mujeres post parto. Las causas de DC se dividen en ateroescleróticas y no ateroescleróticas, existiendo relación del tabaco con  la ateroesclerosis. Este caso presenta a un hombre de 43 años, con tabaquismo pesado, en el contexto de un infarto agudo del miocardio secundario DC,  por lo cual se hace una revisión del daño endotelial que produce el tabaquismo y la fisiopatología de la disección coronaria. La importancia de este reporte  radica en la poca información que existe acerca de los factores de riesgo de este tipo de enfermedad y la presentación clínica inusual del caso.  

Citas

  1. Pretty, H., Dissecting aneurysms of coronary artery in woman aged 42: rupture. Br Med J 1931. 1: p. 667.
  2. D A Ciraulo, R.B.C., Coronary arterial dissection: an unrecognized cause of myocardial infarction, with subsequent coronary arterial patency. chest, 1978. 73: p. 677-679.
  3. D. Hering, C.P., C. Hohmann, H. P. Schultheiss, D. Horstkotte, Prospektive Untersuchung zu Häufigkeit, Pathogenese und Therapie spontaner, koronarangiographisch diagnostizierter Koronararteriendissektionen. Z Kardiol 1998. 87: p. 961-970.
  4. Sharma AK, F.A., Maniar P, et al, Spontaneous coronary artery dissection in a patient with systemic lupus erythematosis. Hawaii Med J, 2003. 62: p. 248–253.
  5. Anisman SD, J.J., Left main coronary artery dissection associated with emotional stress. Dis Mon, 2006. 52: p. 227–253.
  6. Vrints, C.J., Spontaneous coronary artery dissection. Heart, 2010. 96: p. 801-808.
  7. Alberto Berenguer, V.M., Pascual Bordes, José Valencia, Vicente Arrarte, Disección espontánea de arterias coronarias como causa infrecuente de síndromes coronarios agudos. Rev Esp Cardiol, 2003. 56: p. 1017-1021.
  8. Sekip Celik, A.S., Ahmet Altintig, Munevver Yuksel, Mustafa Akin, Hakan Kultursay, Primary spontaneous coronary artery dissections in atherosclerotic patients. Report of nine cases with review of the pertinent literature. European Journal of Cardio-thoracic Surgery, 2001. 20: p. 573-576.
  9. Jason Adler, T.S., Right coronary artery dissection after blunt chest trauma. Injury Extra, 2010. 41: p. 77-78.
  10. Powell, J., Vascular damage from smoking: disease mechanisms at the arterial wall. Vascular Medicine 1998. 3: p. 21-28.
  11. Naoya Ichiba, K.S., Makoto Hirose, Plaque Rupture Causing Spontaneous Coronary Artery Dissection in a Patient With Acute Myocardial Infarction. Circulation, 2000. 101: p. 1754-1755.
  12. Zsuzsanna Orosz, A.C., Nazar Labinskyy, Kira Smith, Pawel M. Kaminski, Peter Ferdinandy, Michael S. Wolin, Aracelie Rivera, and Zoltan Ungvari, Cigarette smoke-induced proinflammatory alterations in the endothelial phenotype: role of NAD(P)H oxidase activation. Am J Physiol Heart Circ Physiol 2007. 292: p. H130-H139.
  13. Kamran M, G.A., Bogal M., Spontaneous coronary artery dissection: case series and review. J Invasive Cardiol, 2008. 20: p. 553-9.
  14. Butler R, W.M., Davies G, Kerr A, Bass N, Armstrong G, et al., Spontaneous dissection of native coronary arteries. Heart, 2005. 91: p. 223-4.
  15. A. Lunebourg, I.L., P. Eggenberger, H.A. Lehr, Sudden Cardiac Death Due to Triple Vessel Coronary Dissection. Circulation, 2008. 117: p. 2038-2040.
  16. Haas JM, P.C., Jones RC., Selective Coronary Arteriography and the Transfemoral Percutaneous Subintimal Dissection of the Coronary Arteries: A Complication of Approach. Circulation, 1968. 38: p. 678-683.
  17. Ohlmann, P., Spontaneous Coronary Dissection: Computed Tomography Appearance and Insights From Intravascular Ultrasound Examination. Circulation, 2006. 113: p. e403-e405.
  18. Gerald Vanzetto, E.B.-C., Gilles Barone-Rochette, Olivier Chavanon, Prevalence, therapeutic management and medium-term prognosis of spontaneous coronary artery dissection: results from a database of 11,605 patients. Eur J Cardiothorac Surg, 2009. 35: p. 250-254.
  19. Arnold J, W.N., van Gaal W,, The role of intravascular ultrasound in the management of spontaneous coronary artery dissection. Cardiovasc Ultrasound, 2008. 6: p. 24.
  20. Raed A. Aqel M.D., F.A.C.C., Gilbert J. , Spontaneous coronary artery dissection, aneurysms, and pseudoaneurysms: a review. Echocardiography 2004. 21: p. 175-182.
  21. Ramirez Moreno A, C.P.R., Guzman Herrera M, Spontaneous dissection of the left main coronary artery treated by multiple stent implantation. Rev Esp Cardiol 2003. 56: p. 417-420.