Liu Chen-Yuan, Juan Chi-Wen, Pai Yu-Lin, Tseng Yung-Zu
Department of Emergency Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan.
Kaohsiung J Med Sci. 2007 Jun;23(6):313-7. doi: 10.1016/S1607-551X(09)70415-2.
A variety of coronary artery disorders, including intramyocardial coronary segments and coronary artery anomalies, can result in sudden cardiac death, especially in young adults. The detection of structural coronary artery abnormalities is important in the management of patients at risk of sudden cardiac death. Coronary artery anomalies occur in about 1% of the population. Congenital absence of left circumflex coronary artery (LCX) is a very rare vascular anomaly, and few cases have been reported in the literature, with a frequency of only 0.003% in all patients who underwent coronary angiography. Although coronary catheterization is the gold standard for the evaluation of coronary arterial patency disease, noninvasive computed tomography (CT) is considered the diagnostic method of choice for the detection and evaluation of coronary artery anomaly. Herein, we report the case of a 17-year-old girl who presented with exertional dyspnea and chest pain and who was studied at our emergency department with the final diagnosis of LCX atresia detected by 64-slice CT. She may be the first case of congenital LCX atresia proved by multislice CT.
多种冠状动脉疾病，包括心肌内冠状动脉节段和冠状动脉异常，可导致心源性猝死，尤其是在年轻人中。检测结构性冠状动脉异常对于管理有心脏性猝死风险的患者很重要。冠状动脉异常在约1%的人群中出现。先天性左旋支冠状动脉（LCX）缺失是一种非常罕见的血管异常，文献中报道的病例很少，在所有接受冠状动脉造影的患者中发生率仅为0.003%。尽管冠状动脉导管插入术是评估冠状动脉通畅性疾病的金标准，但非侵入性计算机断层扫描（CT）被认为是检测和评估冠状动脉异常的首选诊断方法。在此，我们报告一例17岁女孩的病例，她出现劳力性呼吸困难和胸痛，在我们急诊科接受检查，最终通过64层CT诊断为LCX闭锁。她可能是首例经多层CT证实的先天性LCX闭锁病例。
