Jadeed Rayyan, Pethig Klaus, Böcker Dirk
Department of Cardiology, St. Marien Hospital, Hamm, Germany.
Case Rep Cardiol. 2019 Jul 4;2019:2018268. doi: 10.1155/2019/2018268. eCollection 2019.
Coronary artery anomalies (CAAs) are a diverse group of congenital anomalies with an incidence ranging from 0.17% in autopsy cases to 1.2% in patients undergoing coronary angiography. The left coronary artery (LCA) originating from the right coronary sinus is a very rare CAA with a frequency of 0.03%. We present a very rare case of a cardiogenic shock as a consequence of an acute anterolateral myocardial infarction by a totally occlusive lesion in the long left main stem with a complete LCA arising from the right coronary sinus in an 85-year-old female. This lesion was successfully treated with 2 drug-eluting stents. This is perhaps the first published case about cardiogenic shock due to an acute myocardial infarction associated with this type of coronary anomalies, and it presents a special challenge in the catheter laboratory.
冠状动脉异常（CAAs）是一组多样的先天性异常，其发病率在尸检病例中为0.17%，在接受冠状动脉造影的患者中为1.2%。起源于右冠状动脉窦的左冠状动脉（LCA）是一种非常罕见的冠状动脉异常，发生率为0.03%。我们报告了一例非常罕见的病例，一名85岁女性因急性前侧壁心肌梗死导致心源性休克，其左主干长段完全闭塞性病变，且LCA完全起源于右冠状动脉窦。该病变成功植入了2枚药物洗脱支架。这可能是首例关于由这种类型冠状动脉异常相关的急性心肌梗死导致心源性休克的病例报道，并且在导管室中带来了特殊挑战。
