Hong Geu-Ru, Choi Seong Hun, Kang Seok-Min, Lee Moon Hyung, Rim Se-Joong, Jang Yang Soo, Chung Nam Sik
Cardiology Division, Cardiovascular Research Institute, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
Yonsei Med J. 2003 Aug 30;44(4):710-4. doi: 10.3349/ymj.2003.44.4.710.
Among the congenital coronary artery fistulae, multiple coronary artery microfistulae arising from the left and right coronary artery and emptying into the left ventricle are very rare and little is known of their anatomic and clinical features, especially in apical hypertrophic cardiomyopathy. A 67-year- old woman was referred for the evaluation of chest pain at exertion, and shortness of breath. Electrocardiographic and echocardiographic findings were typical of apical hypertrophic cardiomyopathy. Coronary arteriography showed normal epicardial coronary arteries, but multiple coronary artery-left ventricular microfistulae arising from the left and right coronary arteries. Transthoracic color Doppler echocardiography, using a high frequency transducer with a low Nyquist limit, demonstrated multiple coronary artery-left ventricular microfistulae just beneath the apical impulse window.
在先天性冠状动脉瘘中，起源于左、右冠状动脉并汇入左心室的多发性冠状动脉微瘘非常罕见，其解剖和临床特征鲜为人知，尤其是在肥厚型心肌病中。一名67岁女性因劳力性胸痛和气短前来就诊。心电图和超声心动图检查结果为肥厚型心肌病的典型表现。冠状动脉造影显示心外膜冠状动脉正常，但存在起源于左、右冠状动脉的多发性冠状动脉-左心室微瘘。经胸彩色多普勒超声心动图使用低奈奎斯特极限的高频探头，在心尖搏动窗下方显示出多发性冠状动脉-左心室微瘘。
