关键词: 动脉瘤, , 夹层；冠状血管造影术；心肌梗死

Abstract: Objective  To summarize the pathogenesis,  etiology and inducement,  clinical manifestation,  diagnosis,  treatment and related research progress of spontaneous coronary artery dissection,  and to improve its recognition and diagnostic detection rate. Methods  A case of acute myocardial ischemic infarction  caused by spontaneous coronary dissection was retrospectively analyzed,  and relevant literature was reviewed.Results  The patient admitted to the hospital  with chest pain,  and electrocardiogram showed acute inferior wall ST elevation myocardial infarction with increased myocardial enzyme and troponin I,  which was diagnosed as acute myocardial infarction. The reexamination of electrocardiogram  immediately returned to normal. Coronary angiography showed that the stenosis of the right coronary opening was about 70%,  and spontaneous dissection of the proximal middle segment was performed. Percutaneous coronary balloon dilatation (PTCA) + coronary stent implantation was performed. No stenosis was observed postoperatively,  and the stent completely covered the dissection, and  TIMI blood flow was level 3. Conclusion  Acute spontaneous coronary artery dissection is characterized by rapid disease progression and high early mortality. Therefore,  rapid diagnosis and avoidance of misdiagnosis are of great significance. Relevant imaging examinations should be improved as soon as possible in early diagnosis.

Key words: aneurysm, , dissecting； coronary angiography； myocardial infarction