Nakabayashi Keisuke, Okada Hisayuki, Iwanami Yuji, Sugiura Ryo, Oka Toshiaki
Department of Cardiology, Seirei Hamamatsu General Hospital, Shizuoka, Japan.
J Cardiol Cases. 2014 Jul 7;10(3):111-114. doi: 10.1016/j.jccase.2014.06.001. eCollection 2014 Sep.
Anomalous origin of the right coronary artery (ARCA) from the main pulmonary artery is a rare congenital anomaly, unlike the well-known anomalous origin of the left coronary artery (Bland-White-Garland syndrome) from the pulmonary artery. Since most ARCA cases are diagnosed during childhood, few adult cases have been reported. We describe the case of a patient who demonstrated ventricular arrhythmia and low cardiac function due to ischemic heart disease and an ARCA. Coronary angiography revealed flow from the left coronary artery to the pulmonary artery via an epicardial collateral artery and the right coronary artery. Multidetector-row computed tomography provided a definitive diagnosis of ARCA; the patient underwent surgical revascularization. < We incidentally diagnosed ARCA in a patient who experienced ventricular fibrillation. ARCA is a rare condition caused by early-onset cardiac ischemia, which may be a differential diagnosis for this congenital anomaly. Multidetector-row computed tomography is useful for detecting ARCA and determining the coronary artery's course and other congenital anomalies. Immediate surgical treatment for ARCA is strongly recommended to prevent sudden cardiac death.>.
右冠状动脉起源于主肺动脉(ARCA)是一种罕见的先天性异常,与广为人知的左冠状动脉起源于肺动脉(布兰德 - 怀特 - 加兰综合征)不同。由于大多数ARCA病例在儿童期被诊断出来,因此成人病例报道较少。我们描述了一名因缺血性心脏病和ARCA而出现室性心律失常和心功能低下的患者病例。冠状动脉造影显示血流从左冠状动脉经心外膜侧支动脉流向肺动脉和右冠状动脉。多排螺旋计算机断层扫描对ARCA做出了明确诊断;该患者接受了手术血运重建。<我们在一名发生心室颤动的患者中偶然诊断出ARCA。ARCA是一种由早发性心脏缺血引起的罕见病症,对于这种先天性异常可能是一种鉴别诊断。多排螺旋计算机断层扫描对于检测ARCA以及确定冠状动脉走行和其他先天性异常很有用。强烈建议对ARCA立即进行手术治疗以预防心源性猝死。>