Fiorella Annalisa, Basso Pierangelo, Lanzone Saverio, Capestro Francesco, Basile Domenica P, Quagliara Donato, Ciccone Marco Matteo, Favale Stefano
Divisione di Cardiologia, Università degli Studi, Bari.
G Ital Cardiol (Rome). 2010 Oct;11(10):778-82.
Although individual patient outcomes are highly variable, coronary artery anomalies may be associated with sudden cardiac death or acute coronary syndrome.
We report 5 cases of anomalous origin of coronary arteries: a single coronary artery originating from the right sinus of Valsalva, a case of isolated anomalous right coronary artery originating separately from the left sinus of Valsalva, a case of right coronary artery originating between the right and left sinus of Valsalva, a case of anomalous left circumflex artery originating from the right sinus of Valsalva, and a case of anomalous left anterior descending coronary artery originating from the right sinus of Valsalva.
Although in one case the right coronary artery runned between the aorta and the right pulmonary artery, no significant alterations due to coronary artery compression or atheromatous lesions at the anomalous coronary ostia were observed. In all reported cases, symptoms were different as a result of cardiovascular comorbidities. All coronary anomalies were identified at coronary angiography, which was performed for other indications.
The identification of a clear correlation between symptoms and coronary artery anomalies seems challenging in clinical practice. However, it is crucial to confirm or rule out the presence of coronary compression caused by the anomalous origin of coronary arteries.
尽管个体患者的预后差异很大，但冠状动脉异常可能与心源性猝死或急性冠状动脉综合征有关。
我们报告5例冠状动脉起源异常的病例：1例单一冠状动脉起源于瓦尔萨尔瓦右窦，1例孤立的异常右冠状动脉单独起源于瓦尔萨尔瓦左窦，1例右冠状动脉起源于瓦尔萨尔瓦右窦和左窦之间，1例异常左旋支动脉起源于瓦尔萨尔瓦右窦，1例异常左前降支冠状动脉起源于瓦尔萨尔瓦右窦。
尽管在1例病例中右冠状动脉走行于主动脉和右肺动脉之间，但未观察到因冠状动脉受压或异常冠状动脉开口处的动脉粥样硬化病变而导致的明显改变。在所有报告的病例中，由于心血管合并症，症状各不相同。所有冠状动脉异常均在因其他适应证而行的冠状动脉造影中被发现。
在临床实践中，明确症状与冠状动脉异常之间的相关性似乎具有挑战性。然而，确认或排除冠状动脉异常起源导致的冠状动脉受压情况至关重要。
