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表现为急性冠状动脉综合征、心源性休克和完全性心脏传导阻滞的非典型双右冠状动脉

Atypical Double Right Coronary Artery Presenting With Acute Coronary Syndrome, Cardiogenic Shock and Complete Heart Block.

作者信息

Sinha Santosh Kumar, Singh Shravan, Chaturvedi Vikash, Agrawal Puneet, Razi Mahmadula, Mahrotra Anupam, Mishra Vikas, Kumar Mukesh, Abdali Nasar, Khanra Dibbendhu, Thakur Ramesh, Varma Chandra Mohan, Pandey Umeshwar

机构信息

Department of Cardiology, LPS Institute of Cardiology, G. S. V. M. Medical College, Kanpur, Uttar Pradesh 208002, India.

出版信息

J Clin Med Res. 2017 Mar;9(3):221-224. doi: 10.14740/jocmr2848w. Epub 2017 Jan 25.

DOI:10.14740/jocmr2848w
PMID:28179971
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5289143/
Abstract

Double right coronary artery (RCA) is an extremely rare coronary artery anomaly. We here report an atherosclerotic double RCA which appeared after primary percutaneous intervention performed to treat a 34-year-old male presenting with acute inferior myocardial infarction, cardiogenic shock and complete heart block. This is an unusual case as double RCA had been hidden by total atherosclerotic occlusion of the proximal part of the RCA and complete restoration of patency led complete heart block back to normal sinus rhythm.

摘要

双支右冠状动脉（RCA）是一种极其罕见的冠状动脉异常。我们在此报告一例动脉粥样硬化性双支右冠状动脉病例，该病例出现在对一名34岁患有急性下壁心肌梗死、心源性休克和完全性心脏传导阻滞的男性进行的初次经皮介入治疗后。这是一个不寻常的病例，因为双支RCA被RCA近端的完全动脉粥样硬化闭塞所掩盖，而通畅的完全恢复使完全性心脏传导阻滞恢复为正常窦性心律。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/490f/5289143/a7ab52a8ef57/jocmr-09-221-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/490f/5289143/7df95973e092/jocmr-09-221-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/490f/5289143/ff90cb693fdc/jocmr-09-221-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/490f/5289143/9062d7adc025/jocmr-09-221-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/490f/5289143/89f3d4206cb8/jocmr-09-221-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/490f/5289143/a7ab52a8ef57/jocmr-09-221-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/490f/5289143/7df95973e092/jocmr-09-221-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/490f/5289143/ff90cb693fdc/jocmr-09-221-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/490f/5289143/9062d7adc025/jocmr-09-221-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/490f/5289143/89f3d4206cb8/jocmr-09-221-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/490f/5289143/a7ab52a8ef57/jocmr-09-221-g005.jpg

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本文引用的文献

1
Double right coronary artery with acute inferior wall myocardial infarction.双右冠状动脉伴急性下壁心肌梗死。
J Invasive Cardiol. 2008 Feb;20(2):E37-40.
2
Double right coronary artery: report of two cases and review of the literature.双右冠状动脉：两例报告并文献复习
Int J Cardiol. 2008 Nov 12;130(2):e74-7. doi: 10.1016/j.ijcard.2007.11.073. Epub 2008 Jan 22.
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A patient with double right coronary artery and acute inferior myocardial infarction due to the critical lesion in one of them.一名患有双右冠状动脉且因其中一支存在严重病变而导致急性下壁心肌梗死的患者。
Int J Cardiol. 2007 Jun 25;119(1):e30-1. doi: 10.1016/j.ijcard.2007.01.100. Epub 2007 Apr 16.
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Origin and distribution anomalies of the left anterior descending artery in 70,850 adult patients: multicenter data collection.70850例成年患者左前降支动脉的起源和分布异常：多中心数据收集
Catheter Cardiovasc Interv. 2006 Oct;68(4):574-85. doi: 10.1002/ccd.20858.
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Inferior myocardial infarction and extensive atherosclerosis in a patient with double right coronary artery.
Int J Cardiol. 2006 Aug 10;111(2):321-3. doi: 10.1016/j.ijcard.2005.11.028. Epub 2006 Jan 18.
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Atherosclerotic double right coronary artery and ectasia of left coronary arteries in a patient with presented acute coronary syndrome and ventricular tachycardia.
Int J Cardiol. 2005 Jul 10;102(2):341-3. doi: 10.1016/j.ijcard.2004.03.088.
7
An interesting diagnostic dilemma: double right coronary artery or high take off of a large right ventricular branch.一个有趣的诊断难题：双右冠状动脉或粗大右心室分支高位起源。
Int J Cardiol. 2002 Jan;82(1):99-102. doi: 10.1016/s0167-5273(01)00595-2.
8
Double right coronary artery.双右冠状动脉。
Am J Cardiol. 1994 Mar 15;73(8):622. doi: 10.1016/0002-9149(94)90352-2.