Vergara-Uzcategui Carlos Eduardo, das Neves Barbara, Salinas Pablo, Fernández-Ortiz Antonio, Núñez-Gil Iván J
Interventional Cardiology Department, Clinico San Carlos University Hospital, Prof Martin Lagos S/N, Madrid 28040, Spain.
Cardiovascular Research Institute, University Hospital of the Andes, Venezuela.
Eur Heart J Case Rep. 2020 Mar 12;4(2):1-5. doi: 10.1093/ehjcr/ytaa047. eCollection 2020 Jun.
Anomalous origin of a coronary artery from the pulmonary trunk is a small group of rare congenital anomalies present in up to 1% of the population. These patients, in absence of an adequate collateral supply, may present with congestive heart failure secondary to ischaemia, arrhythmia, or sudden cardiac death in up to 90% of cases within the first months of life.
We present four cases diagnosed in adulthood over 10 years in two high-volume centres. The first patient presented with dyspnoea and orthopnoea. The second with chest pain and episodes of non-sustained ventricular tachycardia. The third patient presented during her third pregnancy with chest pain, palpitations, and arrhythmia (non-sustained ventricular tachycardia). The fourth patient presented with sudden cardiac death.
In all cases with anomalous origin of coronary arteries, it is recommendable to consider surgical correction to avoid the progression of ischaemia, congestive heart failure, arrhythmia, and sudden death.
冠状动脉起源于肺动脉干是一小类罕见的先天性异常，在人群中的发生率高达1%。这些患者若缺乏足够的侧支循环，在出生后的头几个月内，高达90%的病例可能会出现继发于缺血的充血性心力衰竭、心律失常或心源性猝死。
我们在两个大型中心报告了10年间成年期诊断的4例病例。首例患者表现为呼吸困难和端坐呼吸。第二例表现为胸痛和非持续性室性心动过速发作。第三例患者在第三次妊娠期间出现胸痛、心悸和心律失常（非持续性室性心动过速）。第四例患者表现为心源性猝死。
对于所有冠状动脉起源异常的病例，建议考虑手术矫正，以避免缺血、充血性心力衰竭、心律失常和猝死的进展。
