Infarto de miocardio con coronarias sanas. Un desafío para el clínico

Miriam Auxiliadora Martín Toro , Miriam Padilla Pérez , Manuel Santiago Herruzo Rojas , Juan Ángel Herrador Fuentes , Javier Torres Llergo , Víctor Aragón Extremera , María Rosa Fernández Olmo , Daniel Salas Bravo , José María Márquez Moreno , Eduardo Vázquez Ruiz de Castroviejo , Juan Carlos Fernández Guerrero
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Abstract

We report a case of a patient with cardiorespiratory arrest due to recovered ventricular fibrillation. In the acute phase, ST segment elevation was observed in anterolateral wall in the electrocardiogram, and severe left ventricular dysfunction was observed on the echocardiogram. However, an urgent cardiac catheterization didńt shown the existence of coronary lesions despite of the severe ventricular dysfunction. At six days there was a complete recovery of ventricular function and echocardiographic alterations and successive electrocardiographic records were also normalized. The peculiarity of the present clinical case is the rapid favorable evolution after the recovery of a sudden death, as well as the diagnostic, prognostic and therapeutic questions it propose.

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心肌梗死伴健康冠状动脉。对临床医生的挑战
我们报告一个病例的病人心肺骤停,由于恢复心室颤动。急性期心电图示前外侧壁ST段抬高,超声心动图示严重左心功能不全。然而,紧急心导管置入术didńt显示存在冠状动脉病变,尽管严重的心室功能障碍。在第6天,心室功能完全恢复,超声心动图改变和连续的心电图记录也正常化。本临床病例的特点是猝死患者恢复后病情的迅速好转,以及由此提出的诊断、预后和治疗问题。
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