Ishii Mie, Masuoka Hiroshi, Emi Yoshiharu, Mori Takuya, Ito Masaaki, Nakano Takeshi
The First Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan.
Circ J. 2003 May;67(5):470-2. doi: 10.1253/circj.67.470.
A 26-year-old man had been diagnosed with a cardiac murmur from birth. In 1998, he was admitted to hospital because of slight fatigue. A grade 5/6 continuous murmur was audible near the right sternal border at the second intercostal space. Doppler echocardiography detected an abnormal flow that suggested that an aneurysm of the right coronary sinus of Valsalva had ruptured into the right ventricular inflow tract. Blood tests showed a 19% step-up in oxygen saturation value between the right atrium and right ventricle, indicating a ventricular septal defect with left to right shunt. Coronary angiography revealed a single coronary artery. Surgical repair was carried out and the patient made an uneventful recovery. This rare combination of a ruptured aneurysm of the sinus of Valsalva coexisting with a ventricular septal defect and a single coronary artery has not been reported previously.
一名26岁男性自出生起就被诊断出患有心脏杂音。1998年，他因轻度疲劳入院。在右胸骨旁第二肋间可闻及5/6级连续性杂音。多普勒超声心动图检测到异常血流，提示瓦氏窦右冠状动脉瘤破裂进入右心室流入道。血液检查显示右心房和右心室之间的氧饱和度值升高了19%，表明存在室间隔缺损并伴有左向右分流。冠状动脉造影显示为单支冠状动脉。患者接受了手术修复，术后恢复顺利。此前尚未有瓦氏窦瘤破裂与室间隔缺损及单支冠状动脉并存这种罕见组合的报道。
