Nascimento Francisco O, Kviatkovsky Milla J, Larrauri-Reyes Maiteder, Beohar Nirat
Department of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, USA.
BMJ Case Rep. 2013 Aug 5;2013:bcr2013200598. doi: 10.1136/bcr-2013-200598.
The presence of a malignant course on the coronary circulation is the second leading cause of sudden cardiac death in young adults. One type of malignant conformation is an anomalous left anterior descending artery (LAD) arising from the right coronary artery (RCA). In a study examining 70,850 patients undergoing coronary angiography, the prevalence of this anomaly was noted in 0.006% of total patients and in 2.3% of congenital coronary anomaly cases. Of the four patients presenting with this anomaly, only one was noted to have an interarterial course of the LAD between the aorta and pulmonary artery. We describe the case of a patient who was incidentally found to have a malignant anomalous LAD arising from the RCA when he presented with a non-ST elevation myocardial infarction due to a ruptured plaque in an obtuse marginal branch. This patient survived for 57 years with no symptoms.
冠状动脉循环出现恶性病变是年轻成年人心脏性猝死的第二大主要原因。一种恶性形态是左前降支动脉（LAD）起源于右冠状动脉（RCA）。在一项对70850例接受冠状动脉造影的患者的研究中，该异常在全部患者中的患病率为0.006%，在先天性冠状动脉异常病例中的患病率为2.3%。在出现这种异常的4例患者中，仅1例被发现LAD走行于主动脉和肺动脉之间。我们描述了1例患者的病例，该患者因钝缘支斑块破裂导致非ST段抬高型心肌梗死就诊时，偶然发现存在起源于RCA的恶性异常LAD。该患者无症状存活了57年。
