avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2023-13-4-312-320ZFMFOOavk-1642Research ArticleРАЗБОР КЛИНИЧЕСКИХ СЛУЧАЕВANALYSIS OF CLINICAL CASESКлинический случай успешного лечения диссекции коронарной артерии и тромбоза левого желудочка у молодого мужчины — носителя гена фактора V Лейдена с транзиторной ишемической атакойA clinical case of successful treatment of coronary artery dissection and left ventricular thrombosis in a young man carrier of factor V Leiden gene and transient ischemic attackhttps://orcid.org/0000-0002-4344-2672ЭнгиноевС. Т.EnginoevS. T.

Сослан Тайсумович Энгиноев

Астрахань

Soslan T. Enginoev

Astrakhan

Soslan.enginoev@gmail.comhttps://orcid.org/0000-0002-4344-2672МартьяноваЮ. Б.MartyanovaYu. B.

Астрахань

Astrakhan

https://orcid.org/0000-0002-7579-4824ЕфремоваЕ. В.EfremovaE. V.

Ульяновск

Ulyanovsk

https://orcid.org/0000-0002-9924-5125ЧерновИ. И.ChernovI. I.

Астрахань

Astrakhan

ФГБОУ «Федеральный центр сердечно-сосудистой хирургии» Министерства здравоохранения Российской Федерации; ФГБОУ ВО «Астраханский ГМУ», Министерства здравоохранения Российской ФедерацииРоссияFederal Center for Cardiovascular Surgery of the Ministry of Health of the Russian Federation; Astrakhan State Medical University of the Ministry of Health of the Russian FederationRussian FederationФГБОУ «Федеральный центр сердечно-сосудистой хирургии» Министерства здравоохранения Российской ФедерацииРоссияFederal Center for Cardiovascular Surgery of the Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО «Ульяновский государственный университет»РоссияUlyanovsk State UniversityRussian Federation202316082023134312320Copyright © Энгиноев С.Т., Мартьянова Ю.Б., Ефремова Е.В., Чернов И.И., 20232023Энгиноев С.Т., Мартьянова Ю.Б., Ефремова Е.В., Чернов И.И.Enginoev S.T., Martyanova Y.B., Efremova E.V., Chernov I.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1642

Одной из причин транзиторной ишемической атаки или ишемического инсульта являются объемные образования левых отделов сердца, в том числе, интракардиальные тромбы. Одним из предрасполагающих факторов тромбообразования является наличие Лейденской мутации, как наиболее распространенной формы наследственной тромбофилии в европейской популяции. В то же время, одной из причин острой сосудистой катастрофы может являться спонтанная диссекция коронарных артерий. Особую сложность представляет дифференциальная диагностика, требующая дополнительных методов обследования (внутрисосудистое ультразвуковое исследование, оптическая когерентная томография) помимо проведения коронарографии. Представленный клинический случай описывает диагностику и успешное лечение спонтанной диссекции передней межжелудочковой артерии, тромбоза левого желудочка, выявление мутации гена фактора V Лейдена у молодого мужчины с анамнезом транзиторной ишемической атаки.

One of the causes of transient ischemic attack or ischemic stroke are mass formations in the left heart. One of the predisposing factors for thrombosis is the presence of the Leiden mutation, as the most common form of hereditary thrombophilia in the European population. At the same time, spontaneous dissection of the coronary arteries (SCA) can be one of the reasons of an acute vascular accident. Of particular difficulty is differential diagnosis, which requires additional examination methods (intravascular ultrasound, optical coherence tomography) in addition to coronary angiography. The presented clinical case describes the diagnosis and successful treatment of spontaneous anterior interventricular artery dissection, left ventricular thrombosis, detection of factor V Leiden gene mutation in a young man with a history of transient ischemic attack

тромб левого желудочкаопухоль сердцаобразование сердцатромбэктомиятранзиторная ишемическая атакаleft ventricular thrombusheart tumorheart formationthrombectomytransient ischemic attackReferencesMassussi M, Scotti A, Lip GYH et al. Left ventricular thrombosis: new perspectives on an old problem. Eur Heart J Cardiovasc Pharmacother. 2021; 7: 158–167. doi: 10.1093/ehjcvp/pvaa066Massussi M, Scotti A, Lip GYH et al. Left ventricular thrombosis: new perspectives on an old problem. Eur Heart J Cardiovasc Pharmacother. 2021; 7: 158–167. doi: 10.1093/ehjcvp/pvaa066Lattuca B, Bouziri N, Kerneis M, et al; ACTION Study Group. Antithrombotic therapy for patients with left ventricular mural thrombus. J Am Coll Cardiol. 2020; 75: 1676–1685. doi: 10.1016/j.jacc.2020.01.057Lattuca B, Bouziri N, Kerneis M, et al; ACTION Study Group. Antithrombotic therapy for patients with left ventricular mural thrombus. J Am Coll Cardiol. 2020; 75: 1676–1685. doi: 10.1016/j.jacc.2020.01.057Stevens SM, Woller SC, Bauer KA, et al. Guidance for the evaluation and treatment of hereditary and acquired thrombophilia. J Thromb Thrombolysis. 2016; 41(1): 154-64. doi:10.1007/s11239-015-1316-1Stevens SM, Woller SC, Bauer KA, et al. Guidance for the evaluation and treatment of hereditary and acquired thrombophilia. J Thromb Thrombolysis. 2016; 41(1): 154-64. doi:10.1007/s11239-015-1316-1de Moerloose P., Reber G., Perrier A. et al. Prevalence of factor V Leiden and prothrombin G20210A mutations in unselected patients with venous thromboembolism. Br J Haematol. 2000; 110(1): 125-9. doi: 10.1046/j.1365-2141.2000.02039.x.de Moerloose P., Reber G., Perrier A. et al. Prevalence of factor V Leiden and prothrombin G20210A mutations in unselected patients with venous thromboembolism. Br J Haematol. 2000; 110(1): 125-9. doi: 10.1046/j.1365-2141.2000.02039.x.Stolz E, Kemkes-Matthes B, Pötzsch B et al. Screening for thrombophilic risk factors among 25 German patients with cerebral venous thrombosis. Acta Neurol Scand. 2000; 102(1): 31-6.Stolz E, Kemkes-Matthes B, Pötzsch B et al. Screening for thrombophilic risk factors among 25 German patients with cerebral venous thrombosis. Acta Neurol Scand. 2000; 102(1): 31-6.Nishiguchi T., Tanaka A., Ozaki Y. et al. Prevalence of spontaneous coronary artery dissection in patients with acute coronary syndrome. Eur Heart J Acute Cardiovasc Care. 2016; 5(3): 263-70. doi: 10.1177/2048872613504310.Nishiguchi T., Tanaka A., Ozaki Y. et al. Prevalence of spontaneous coronary artery dissection in patients with acute coronary syndrome. Eur Heart J Acute Cardiovasc Care. 2016; 5(3): 263-70. doi: 10.1177/2048872613504310.Yang C, Alfadhel M, Saw J. Spontaneous Coronary Artery Dissection: Latest Developments and New Frontiers. Curr Atheroscler Rep. 2020. 30; 22(9): 49. doi: 10.1007/s11883-02000866-4.Yang C, Alfadhel M, Saw J. Spontaneous Coronary Artery Dissection: Latest Developments and New Frontiers. Curr Atheroscler Rep. 2020. 30; 22(9): 49. doi: 10.1007/s11883-02000866-4.Cader FA, Banerjee S, Gulati M. Sex Differences in Acute Coronary Syndromes: A Global Perspective. J Cardiovasc Dev Dis. 2022 Jul 27; 9(8): 239. doi: 10.3390/jcdd9080239.Cader FA, Banerjee S, Gulati M. Sex Differences in Acute Coronary Syndromes: A Global Perspective. J Cardiovasc Dev Dis. 2022 Jul 27; 9(8): 239. doi: 10.3390/jcdd9080239.Vanzetto G, Berger-Coz E, Barone-Rochette G, et al. Prevalence, therapeutic management and medium-term prognosis of spontaneous coronary artery dissection: results from a database of 11,605 patients. Eur J Cardio-Thoracic Surg Off J Eur Assoc Cardio-Thoracic Surg. 2009; 35: 250–4. doi: 10.1016/j.ejcts.2008.10.023.Vanzetto G, Berger-Coz E, Barone-Rochette G, et al. Prevalence, therapeutic management and medium-term prognosis of spontaneous coronary artery dissection: results from a database of 11,605 patients. Eur J Cardio-Thoracic Surg Off J Eur Assoc Cardio-Thoracic Surg. 2009; 35: 250–4. doi: 10.1016/j.ejcts.2008.10.023.Saw J. Coronary angiogram classification of spontaneous coronary artery dissection. Catheter Cardiovasc Interv. 2014 Dec 1; 84(7): 1115-22. doi: 10.1002/ccd.25293.Saw J. Coronary angiogram classification of spontaneous coronary artery dissection. Catheter Cardiovasc Interv. 2014 Dec 1; 84(7): 1115-22. doi: 10.1002/ccd.25293.Levine G.N., McEvoy J.W., Fang J.C. et al. Management of Patients at Risk for and With Left Ventricular Thrombus: A Scientific Statement From the American Heart Association. Circulation. 2022; 146(15): e205-e223. doi: 10.1161/CIR.0000000000001092.Levine G.N., McEvoy J.W., Fang J.C. et al. Management of Patients at Risk for and With Left Ventricular Thrombus: A Scientific Statement From the American Heart Association. Circulation. 2022; 146(15): e205-e223. doi: 10.1161/CIR.0000000000001092.Bulluck H., Chan M.H.H., Paradies V. et al. Incidence and predictors of left ventricular thrombus by cardiovascular magnetic resonance in acute ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: a meta-analysis. J Cardiovasc Magn Reson. 2018; 20:7 2. doi: 10.1186/s12968-018-0494-3Bulluck H., Chan M.H.H., Paradies V. et al. Incidence and predictors of left ventricular thrombus by cardiovascular magnetic resonance in acute ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: a meta-analysis. J Cardiovasc Magn Reson. 2018; 20:7 2. doi: 10.1186/s12968-018-0494-3Velangi P.S., Choo C., Chen K.A. et al. Long-term embolic outcomes after detection of left ventricular thrombus by late gadolinium enhancement cardiovascular magnetic resonance imaging: a matched cohort study. Circ Cardiovasc Imaging. 2019; 12: e009723. doi: 10.1161/CIRCIMAGING.119.009723Velangi P.S., Choo C., Chen K.A. et al. Long-term embolic outcomes after detection of left ventricular thrombus by late gadolinium enhancement cardiovascular magnetic resonance imaging: a matched cohort study. Circ Cardiovasc Imaging. 2019; 12: e009723. doi: 10.1161/CIRCIMAGING.119.009723Lee J.M., Park J.J., Jung H.W., et al. Left ventricular thrombus and subsequent thromboembolism, comparison of anticoagulation, surgical removal, and antiplatelet agents. J Atheroscler Thromb 2013; 20(1): 73-93. doi: 10.5551/jat.13540.Lee J.M., Park J.J., Jung H.W., et al. Left ventricular thrombus and subsequent thromboembolism, comparison of anticoagulation, surgical removal, and antiplatelet agents. J Atheroscler Thromb 2013; 20(1): 73-93. doi: 10.5551/jat.13540.Зотова И.В., Затейщиков Д.А. Наследственная тромбофилия и венозные тромбоэмболические осложнения: правила тестирования в клинической практике. Российский кардиологический журнал. 2020; 25(S3): 4024. doi:10.15829/1560-4071-2020-4024Zotova I.V., Zateyshchikov D.A. Inherited thrombophilia and venous thromboembolism: testing rules in clinical practice. Russian Journal of Cardiology. 2020; 25(S3): 4024. doi:10.15829/1560-4071-2020-4024 [In Russian]Khan T., Danyi P., Topaz O., et al. Spontaneous coronary artery dissection in a young man with a factor v leiden gene mutation: a case report and review of the literature. Int J Angiol Off Publ Int Coll Angiol Inc. 2013; 22: 251–4. doi: 10.1055/s-0033-1347932.Khan T., Danyi P., Topaz O., et al. Spontaneous coronary artery dissection in a young man with a factor v leiden gene mutation: a case report and review of the literature. Int J Angiol Off Publ Int Coll Angiol Inc. 2013; 22: 251–4. doi: 10.1055/s-0033-1347932.Joo J.H., Caldera A.E., Divakaran V.G. Spontaneous coronary artery dissection with left ventricular thrombus. Proc (Bayl Univ Med Cent) 2019; 32: 99–100. doi: 10.1080/08998280.2018.1507974.Joo J.H., Caldera A.E., Divakaran V.G. Spontaneous coronary artery dissection with left ventricular thrombus. Proc (Bayl Univ Med Cent) 2019; 32: 99–100. doi: 10.1080/08998280.2018.1507974.Pedretti R.F.E., Hansen D., Ambrosetti M. et al. How to optimize the adherence to a guideline-directed medical therapy in the secondary prevention of cardiovascular diseases: a clinical consensus statement from the European Association of Preventive Cardiology (EAPC). Eur J Prev Cardiol. 2023 Jan 24; 30(2): 149-166. doi: 10.1093/eurjpc/zwac204.Pedretti R.F.E., Hansen D., Ambrosetti M. et al. How to optimize the adherence to a guideline-directed medical therapy in the secondary prevention of cardiovascular diseases: a clinical consensus statement from the European Association of Preventive Cardiology (EAPC). Eur J Prev Cardiol. 2023 Jan 24; 30(2): 149-166. doi: 10.1093/eurjpc/zwac204.Naderi SH, Bestwick JP, Wald DS. Adherence to drugs that prevent cardiovascular disease: meta-analysis on 376,162 patients. Am J Med 2012; 125: 882–887.e1. doi: 10.1016/j.amjmed.2011.12.013.Naderi SH, Bestwick JP, Wald DS. Adherence to drugs that prevent cardiovascular disease: meta-analysis on 376,162 patients. Am J Med 2012; 125: 882–887.e1. doi: 10.1016/j.amjmed.2011.12.013.

The authors declare that there are no conflicts of interest present.