Liddy Stephen, Roy Andrew K, McCreery Charles
Department of Cardiology, St James's Hospital, Dublin, Ireland.
BMJ Case Rep. 2014 Mar 28;2014:bcr2013203344. doi: 10.1136/bcr-2013-203344.
A 40-year-old man with no cardiac history was admitted for evaluation of atypical chest pain of 1-month duration. On investigation he was found to have hypertrophic cardiomyopathy and an anomalous right coronary artery arising from the left sinus of Valsalva. This is of great clinical significance as both these conditions are independently associated with sudden cardiac death. Following extensive risk assessment and detailed discussion with the patient, he was discharged on medical therapy, comprising bisoprolol, aspirin and rosuvastatin. He has remained free of symptoms for 1 year. This report describes the rare coexistence of these two distinct clinical entities, examines the various treatment options and provides support for medical management as an acceptable treatment strategy in appropriately selected cases.
一名无心脏病史的40岁男性因持续1个月的非典型胸痛入院评估。检查发现他患有肥厚型心肌病和一条起源于左冠状动脉窦的异常右冠状动脉。这具有重大临床意义，因为这两种情况均独立与心源性猝死相关。经过广泛的风险评估并与患者详细讨论后，他出院接受药物治疗，包括比索洛尔、阿司匹林和瑞舒伐他汀。他已无症状1年。本报告描述了这两种不同临床实体罕见的共存情况，探讨了各种治疗选择，并为在适当选择的病例中采用药物治疗作为可接受的治疗策略提供了支持。
