Díaz Rienzi, Vega Jorge
Departamento de Medicina, Escuela de Medicina, Universidad de Valparaíso, Chile.
Rev Med Chil. 2016 Oct;144(10):1277-1286. doi: 10.4067/S0034-98872016001000007.
Coronary anomalies are rare heart diseases that can cause sudden cardiac death, especially in young individuals. Coronary computed tomography angiography delivers a three-dimensional view of excellent quality with information of the origin, course and anatomic relationships of the anomalous vessel, allowing differentiation between benign and malignant variants, entities that require different management and treatment.
To show that coronary computed tomography angiography is the non-invasive technique of choice for the evaluation of a coronary anomaly due to its high diagnostic accuracy.
Between 2008 and 2014, 368 coronary computed tomography angiographies were carried out. Six (1.6%) patients had a coronary anomaly.
The age of these six patients ranged from 38 to 82 years (five were women). The coronary computed tomography angiography was requested due to cardiac symptoms (angina and dyspnea) in two patients, after a selective coronary arteriography to obtain additional information of the coronary anomaly in three patients, and after a cardiorespiratory arrest in one patient. Three patients had an anomaly of the right coronary artery, two patients had an anomaly of the left coronary artery and one patient had absent left main coronary artery. In five patients the coronary anomaly was malignant.
Coronary computed tomography angiography is a robust diagnostic method to evaluate patients with suspected coronary anomalies.
冠状动脉异常是一种罕见的心脏病，可导致心源性猝死，尤其是在年轻人中。冠状动脉计算机断层扫描血管造影可提供高质量的三维图像，显示异常血管的起源、走行及解剖关系，有助于区分良性和恶性变异，而这两类病变需要不同的处理和治疗方法。
证明冠状动脉计算机断层扫描血管造影因其高诊断准确性，是评估冠状动脉异常的首选无创技术。
2008年至2014年间，共进行了368例冠状动脉计算机断层扫描血管造影。其中6例（1.6%）患者存在冠状动脉异常。
这6例患者年龄在38至82岁之间（5例为女性）。2例患者因心脏症状（心绞痛和呼吸困难）接受冠状动脉计算机断层扫描血管造影检查，3例患者在选择性冠状动脉造影后进行该检查以获取冠状动脉异常的更多信息，1例患者在心肺骤停后进行检查。3例患者右冠状动脉异常，2例患者左冠状动脉异常，1例患者左主干冠状动脉缺如。5例患者的冠状动脉异常为恶性。
冠状动脉计算机断层扫描血管造影是评估疑似冠状动脉异常患者的可靠诊断方法。
