左冠状动脉异常起源于肺动脉致心力衰竭。

SUNY Upstate Medical University, Syracuse, USA.

Upstate University Hospital, Syracuse, NY, USA.

J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096221084909. doi: 10.1177/23247096221084909.

Coronary arteries arising from the pulmonary artery have an incidence of 0.002% in the general population. We present a 29-year-old woman who presented to our hospital with acute decompensated heart failure and atrial fibrillation with a rapid ventricular rate. She underwent a cardiac catheterization to rule out ischemic disease, which revealed retrograde contrast flow through the left coronary artery from the right coronary artery. A coronary computed tomography (CT) angiogram was pursued which showed the presence of an anomalous left coronary artery arising from the pulmonary artery (ALCAPA). For the management of her atrial fibrillation, she was electrically cardioverted. She was discharged on guideline-directed medical therapy for her heart failure, with a cardiac surgery referral for the surgical fixation of her ALCAPA.

发自肺动脉的冠状动脉在普通人群中的发生率为 0.002%。我们介绍一位 29 岁女性，因急性失代偿性心力衰竭和快速心室率的心房颤动就诊于我院。她接受了心脏导管检查以排除缺血性疾病，结果显示逆行对比剂从右冠状动脉经左冠状动脉流动。进一步进行冠状动脉计算机断层（CT）血管造影，发现存在起源于肺动脉的异常左冠状动脉（ALCAPA）。为了治疗她的心房颤动，对她进行了电复律。她出院时接受了心力衰竭的指南指导药物治疗，并被转介至心脏外科，以手术固定她的 ALCAPA。