Przybojewski J Z, Rossouw J
S Afr Med J. 1986 Jan 18;69(2):133-6.
A 33-year-old white man had exertional angina pectoris, followed by angina pectoris at rest, and then episodes of ischaemic acute pulmonary oedema associated with angina pectoris. Selective coronary angiography delineated an isolated long-segment stenosis of the left mainstem coronary artery with no other lesions. We believe that the mainstem obstruction was due to coronary artery fibromuscular hyperplasia, a condition rarely affecting the coronary artery circulation. At operation three coronary artery bypass grafts were inserted, one to the left anterior descending artery and two to the left circumflex coronary artery, with a most successful result. The patient's recurrent acute pulmonary oedema was due to severe myocardial ischaemia; the possibility of superadded coronary vasospasm aggravating the obstruction cannot be entirely discounted.
一名33岁的白人男性先是出现劳力性心绞痛，随后发展为静息性心绞痛，接着又出现与心绞痛相关的缺血性急性肺水肿发作。选择性冠状动脉造影显示左主干冠状动脉存在孤立的长段狭窄，无其他病变。我们认为主干阻塞是由于冠状动脉纤维肌性增生所致，这种情况很少影响冠状动脉循环。手术中植入了三根冠状动脉旁路移植血管，一根至左前降支动脉，两根至左旋支冠状动脉，手术结果非常成功。患者反复出现急性肺水肿是由于严重的心肌缺血；不能完全排除叠加的冠状动脉痉挛加重阻塞的可能性。
