Robert and Suzanne Tomisch Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, J1-5, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA.
J Nucl Cardiol. 2018 Aug;25(4):1415-1417. doi: 10.1007/s12350-017-0983-z. Epub 2017 Jul 13.
Anomalous aortic origin of a coronary artery is a rare congenital condition that has variable presentations from atypical chest pain to syncope and cardiac arrest. Commonly used myocardial perfusion imaging techniques, stress agents, and perfusion agents may have limited ability to detect inducible ischemia in this rare patient group. We herein describe a unique case of anomalous left main coronary artery from a common right coronary sinus ostium with a subpulmonic and intramyocardial course. This patient had multiple atypical chest pain presentations and multiple-negative pharmacologic single-photon emission-computed tomography stress tests performed. Significant ischemia was detected via N-13 exercise cardiac positron emission tomography and with surgical intervention she had resolution of her symptoms.
冠状动脉异常起源是一种罕见的先天性疾病，其临床表现从非典型胸痛到晕厥和心脏骤停不等。常用的心肌灌注成像技术、应激剂和灌注剂可能对这一罕见患者群体中的可诱导缺血的检测能力有限。我们在此描述了一个独特的病例，即异常左主干冠状动脉起源于共同的右冠状动脉窦口，伴有肺动脉下和心肌内走行。该患者有多次非典型胸痛发作，且多次进行了药物单光子发射计算机断层扫描应激试验，结果均为阴性。通过 N-13 运动心脏正电子发射断层扫描检测到显著的缺血，且通过手术干预，她的症状得到了缓解。
