Paz Soldán-Patiño Claudia Patricia, Rojas-Velasco Gustavo, Arias-Mendoza María Alexandra, Enríquez-Gómez Edmundo, Meave-González Aloha, Álvarez-Sangabriel Amada, Amigo Mary Carmen, Vargas-Barrón Jesús, Martínez-Sánchez Carlos Rodolfo
Residente Ecocardiografía. Instituto Nacional de Cardiología Ignacio Chávez. México D.F., México.
Arch Cardiol Mex. 2012 Apr-Jun;82(2):120-4.
Coronary artery aneurysms are a relatively infrequent finding with an incidence of 1% to 2% per year. Its cause can be atherosclerosis, congenital or due to other causes less common. Its initial manifestation can be myocardial infarction and sudden death as a result of rupture or distal embolization. The large coronary aneurysms, non-atherosclerotic, located in the common part of the left main coronary artery are exceptional. The diagnostic method of choice is the coronary angiography; however, non-invasive techniques such as transthoracic including tridimensional mode and transesophageal echocardiography, magnetic resonance imaging and computed tomography may have an important role in the detection and follow-up of these anomalies. The natural history of coronary aneurysm is not quite known. We present the case of a patient of 44 years, following an acute coronary event was diagnosed with an aneurysm in the left main and antiphospholipid syndrome. The patient received conservative treatment on the basis of antiplatelet and anticoagulant without presenting major cardiovascular events or other complications in 12 years of follow-up.
冠状动脉瘤是一种相对少见的病症,每年的发病率为1%至2%。其病因可能是动脉粥样硬化、先天性的或其他较罕见的原因。其初始表现可能是心肌梗死以及因破裂或远端栓塞导致的猝死。位于左冠状动脉主干常见部位的非动脉粥样硬化性大冠状动脉瘤非常罕见。首选的诊断方法是冠状动脉造影;然而,诸如包括三维模式的经胸以及经食管超声心动图、磁共振成像和计算机断层扫描等非侵入性技术在这些异常的检测和随访中可能发挥重要作用。冠状动脉瘤的自然病程尚不完全清楚。我们介绍了一名44岁患者的病例,该患者在急性冠状动脉事件后被诊断出左主干动脉瘤和抗磷脂综合征。患者在接受抗血小板和抗凝治疗的基础上进行了保守治疗,在12年的随访中未出现重大心血管事件或其他并发症。