Abreu Glória, Nabais Sérgio, Enes Vânia, Marques Jorge, Costa João, Correia Adelino
Serviço de Cardiologia, Hospital de Braga, Braga, Portugal.
Serviço de Cardiologia, Hospital de Braga, Braga, Portugal.
Rev Port Cardiol. 2014 Apr;33(4):241.e1-5. doi: 10.1016/j.repc.2013.11.002. Epub 2014 May 5.
Intercoronary communication or 'coronary arcade' is a rare congenital coronary anomaly. We present the case of a 65-year-old man with atypical chest pain for four months. The 12-lead ECG and echocardiogram were normal. Treadmill exercise testing was interrupted at peak exercise due to consecutive salvos of ventricular premature beats, without significant ST-T changes. Coronary angiography showed no significant coronary stenosis, but a connection between the right coronary and circumflex arteries was observed, consistent with coronary arcade. The functional importance of this variant is not clear, but it may cause myocardial ischemia by coronary steal or function as a natural bypass, in which case it may play a protective role in the myocardium if significant atherosclerosis develops.
冠状动脉间交通或“冠状动脉弓”是一种罕见的先天性冠状动脉异常。我们报告一例65岁男性，有4个月的非典型胸痛症状。12导联心电图和超声心动图均正常。平板运动试验在运动高峰时因连续出现室性早搏而中断，ST-T段无明显改变。冠状动脉造影显示无明显冠状动脉狭窄，但观察到右冠状动脉和回旋支之间有连接，符合冠状动脉弓表现。这种变异的功能重要性尚不清楚，但它可能通过冠状动脉窃血导致心肌缺血，或起到自然旁路的作用，在这种情况下，如果发生严重动脉粥样硬化，它可能对心肌起到保护作用。
