Celik T, Iyisoy A, Arslan Z
Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey.
Cardiovasc J Afr. 2009 Nov-Dec;20(6):355-7.
In most patients, the left anterior descending coronary artery (LAD) feeds the anterior aspect of the interventricular septum and a large segment of the anterior wall of the left ventricle. It then passes around the left ventricular apex to supply that area as well. However, in some cases, the LAD is shorter and terminates either at or before the left ventricular apex. The latter in these cases is instead supplied by a long posterior descending coronary artery (PDA), originating from the right coronary artery (RCA) at the crux, then passing along the entire length of the posterior interventricular groove, and either terminating at the apex or extending beyond it to pass upward in the anterior interventricular groove. In this case report, we describe a 50-year-old man with an apical perfusion defect on stress myocardial perfusion imaging in whom diagnostic coronary angiography revealed that the left ventricular apex was supplied by a large, obtuse marginal branch of the left circumflex coronary artery (LCX) instead of the LAD.
在大多数患者中，左冠状动脉前降支（LAD）为室间隔的前壁及左心室前壁的大部分供血。然后它绕过左心室心尖，为该区域供血。然而，在某些情况下，LAD较短，在左心室心尖处或之前就终止。在这些情况下，左心室心尖由一条长的后降支冠状动脉（PDA）供血，该动脉起源于右冠状动脉（RCA）在心脏十字交叉处，然后沿后室间沟全长走行，要么在心脏尖部终止，要么延伸至其上方并在前室间沟向上走行。在本病例报告中，我们描述了一名50岁男性，其在负荷心肌灌注成像上有心脏尖部灌注缺损，诊断性冠状动脉造影显示左心室心尖由左旋支冠状动脉（LCX）的一个大的钝缘支供血，而非LAD。
