Gao Xiangyu, Li Hongwei, Chen Hui
Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, China.
Intern Med. 2015;54(20):2619-23. doi: 10.2169/internalmedicine.54.4147. Epub 2015 Oct 15.
We herein report the case of a 60-year-old man who presented with chest discomfort. Coronary angiography demonstrated that the short left anterior descending artery (LAD) arose from the left main coronary artery and the long LAD from the right coronary sinus of Valsalva, which was confirmed by 64-slice multidetector computed tomography coronary angiography. Single-photon emission computed tomography revealed a significant, almost irreversible degree of hypoperfusion in the anterior wall of the left ventricle, thus indicating that the short LAD was associated with myocardial ischemia and severe atherosclerotic lesions. Therefore, SPECT showed that the myocardium was largely necrotic, and we did not perform angioplasty for the short LAD.
我们在此报告一例60岁男性患者，其表现为胸部不适。冠状动脉造影显示，短的左前降支动脉（LAD）起源于左冠状动脉主干，而长的LAD起源于瓦尔萨尔瓦右冠状窦，这一点通过64层多排螺旋计算机断层扫描冠状动脉造影得到证实。单光子发射计算机断层扫描显示左心室前壁存在显著的、几乎不可逆的灌注不足，表明短LAD与心肌缺血及严重动脉粥样硬化病变相关。因此，SPECT显示心肌大部分坏死，我们未对短LAD进行血管成形术。
