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Successful treatment of left main shock syndrome induced by thrombosed coronary artery dissection: A case report.

Abstract Left main shock syndrome (LMSS) induced by thrombosed coronary artery dissection is very rare and has a fatal prognosis. Optimal treatment strategy includes early reperfusion and hemodynamic support to prevent cardiogenic shock. However, it involves the extension of technical difficulties under different conditions.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29703012
OWN - NLM
STAT- MEDLINE
DCOM- 20180514
LR  - 20180516
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 17
DP  - 2018 Apr
TI  - Successful treatment of left main shock syndrome induced by thrombosed coronary
      artery dissection: A case report.
PG  - e0496
LID - 10.1097/MD.0000000000010496 [doi]
AB  - RATIONALE: Left main shock syndrome (LMSS) induced by thrombosed coronary artery 
      dissection is very rare and has a fatal prognosis. Optimal treatment strategy
      includes early reperfusion and hemodynamic support to prevent cardiogenic shock. 
      However, it involves the extension of technical difficulties under different
      conditions. PATIENT CONCERNS: A 49-year-old woman developed symptoms of left main
      shock syndrome. The main clinical manifestations were retrosternal pain radiating
      to his back and left shoulder, heavy sweating, palpitation and brachypnea.
      DIAGNOSES: Acute anterioseptal myocardial infarction (Killip Class IV) with
      cardiogenic shock and arrhythmia including ventricular tachycardia and idionodal 
      rhythm, and coronary artery dissection. INTERVENTIONS: A thrombus aspiration
      procedure was performed for the establishment of coronary flow under intra-aortic
      balloon pumping (IABP) support. Her coronary angiographic finding demonstrated a 
      dissection in the mid-distal segment of the left main coronary artery where a
      sirolimus-eluting stent was deployed. Then, the veno-arterial extra-corporal
      membrane oxygenation (ECMO) was placed to improve severe cardiac dysfunction and 
      end-organ failure. OUTCOMES: The patient had a good outcome without active
      symptoms. LESSONS: Thrombosis on the basis of coronary dissection is a very rare 
      cause of LMSS. Successful team treatments, including the prompt thrombus
      aspiration and stent repair of artery dissection, potent IABP and ECMO support
      are important to improve the clinical outcome.
FAU - Bai, Xiaojun
AU  - Bai X
AD  - Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong
      University, Xi'an, Shaanxi Province, China.
FAU - Zhang, Weiping
AU  - Zhang W
FAU - Yuan, Zuyi
AU  - Yuan Z
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - Coronary Artery Dissection, Spontaneous
SB  - AIM
SB  - IM
MH  - Arrhythmias, Cardiac
MH  - Coronary Vessel Anomalies/*complications
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Myocardial Infarction/*complications
MH  - Shock, Cardiogenic/*complications
MH  - Syndrome
MH  - Thrombosis/*complications/surgery
MH  - Vascular Diseases/complications/*congenital
PMC - PMC5944530
EDAT- 2018/04/29 06:00
MHDA- 2018/05/15 06:00
CRDT- 2018/04/29 06:00
PHST- 2018/04/29 06:00 [entrez]
PHST- 2018/04/29 06:00 [pubmed]
PHST- 2018/05/15 06:00 [medline]
AID - 10.1097/MD.0000000000010496 [doi]
AID - 00005792-201804270-00044 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Apr;97(17):e0496. doi: 10.1097/MD.0000000000010496.