从应激试验到ST段抬高型心肌梗死：冠状动脉CT血管造影在诊断和管理起源于左冠状动脉窦的异常右冠状动脉中的应用。
Stress test to STEMI: Utility of coronary CTA in the diagnosis and management of anomalous right coronary artery from the left coronary cusp.
作者信息
Das Anshuman, Joseph Ajay, Jolly Neeraj, Kalra Dinesh K
机构信息
Department of Medicine, Division of Cardiology, Section of Interventional Cardiology, Rush University Medical Center, Chicago, IL, USA.
Advanced Cardiac Imaging, Rush University Medical Center, Chicago, IL, USA.
出版信息
Echocardiography. 2017 Oct;34(10):1519-1523. doi: 10.1111/echo.13700.
A 42-year-old woman presented to the emergency department with chest pain. Acute coronary syndrome was ruled out. During dobutamine stress echocardiography (DSE), she developed chest pain and inferior ST elevation. Emergent coronary angiography revealed no culprit lesions but did show an anomalous right coronary artery (RCA). Coronary CT angiography (CCTA) confirmed an anomalous RCA arising from the left coronary cusp with a slit-like ostium and interarterial course (ARCA-LCC-IA). Herein, we review the extant literature on ARCA-LCC-IA, its clinical presentation, the vital role of CTA and MRI in its diagnosis, as well as challenges and controversies surrounding management.
一名42岁女性因胸痛就诊于急诊科。急性冠状动脉综合征被排除。在多巴酚丁胺负荷超声心动图（DSE）检查期间，她出现胸痛及下壁ST段抬高。急诊冠状动脉造影未发现罪犯病变，但显示有右冠状动脉（RCA）异常。冠状动脉CT血管造影（CCTA）证实右冠状动脉起源于左冠状动脉窦，开口呈裂隙状，走行于动脉之间（ARCA-LCC-IA）。在此，我们回顾了关于ARCA-LCC-IA的现有文献、其临床表现、CTA和MRI在其诊断中的重要作用，以及围绕治疗的挑战和争议。
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