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冠状动脉异常的起源、走行及角度——病例报告

Origin, Course, and Angulation of Coronary Artery Anomaly - A Case Report.

作者信息

Roberto Schetz Alves Matheus, Momoli Júlia, Lindsey Pilato Emily, Lenci Marques Gustavo

机构信息

Medicine, Pontifical Catholic University of Paraná, Curitiba, BRA.

Internal Medicine, Federal University of Parana, Curitiba, BRA.

出版信息

Cureus. 2022 Sep 1;14(9):e28669. doi: 10.7759/cureus.28669. eCollection 2022 Sep.

DOI:10.7759/cureus.28669
PMID:36199653
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9526454/
Abstract

Congenital coronary artery anomalies are a rare diagnosis that can be silent when the patient is asymptomatic. Although these abnormalities may, in most cases, not present clinical alterations, in some cases, they prove to be a cause of myocardial ischemia and sudden death. We report the case of a 20-year-old asymptomatic patient, seen in a routine cardiology consultation, evidenced in an ergometric test ST-segment depression. In this case, follow-up was carried out with coronary angiotomography and scintigraphy to understand the reason for this finding. After the angiotomography has evidenced the diagnosis of anomalous origin and course of the right coronary artery and the trunk of the left coronary artery, in addition to anomalous angulation of the right coronary vessel.

摘要

先天性冠状动脉异常是一种罕见的诊断，当患者无症状时可能不被察觉。虽然这些异常在大多数情况下可能不会出现临床改变，但在某些情况下，它们被证明是心肌缺血和猝死的原因。我们报告一例20岁无症状患者，在常规心脏病咨询中被发现，运动试验显示ST段压低。在该病例中，通过冠状动脉血管造影和闪烁扫描进行随访，以了解这一发现的原因。血管造影证实了右冠状动脉和左冠状动脉主干的起源和走行异常，以及右冠状动脉血管的异常成角。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/fcb1b67b63b6/cureus-0014-00000028669-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/cfc3c9acdede/cureus-0014-00000028669-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/d303d7280940/cureus-0014-00000028669-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/ec2593eb302b/cureus-0014-00000028669-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/64633553df8b/cureus-0014-00000028669-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/84e5526a3b3f/cureus-0014-00000028669-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/f806160c48ef/cureus-0014-00000028669-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/fcb1b67b63b6/cureus-0014-00000028669-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/cfc3c9acdede/cureus-0014-00000028669-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/d303d7280940/cureus-0014-00000028669-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/ec2593eb302b/cureus-0014-00000028669-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/64633553df8b/cureus-0014-00000028669-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/84e5526a3b3f/cureus-0014-00000028669-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/f806160c48ef/cureus-0014-00000028669-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d8/9526454/fcb1b67b63b6/cureus-0014-00000028669-i07.jpg

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本文引用的文献

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Anomalous Origin of the Circumflex Coronary Artery from the Right Pulmonary Artery: Diagnosis Through Cardiac CT.回旋支冠状动脉起源于右肺动脉异常：通过心脏CT诊断
Arq Bras Cardiol. 2021 Jul;117(1 suppl 1):8-11. doi: 10.36660/abc.20200060.
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Coronary artery anomalies: Why should we diagnose them in young athletes, by what means, and for what aims?
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Anatomic spectrum of left coronary artery anomalies and associated mechanisms of coronary insufficiency.左冠状动脉异常的解剖学谱及相关冠状动脉供血不足机制
Catheter Cardiovasc Interv. 2018 Aug 1;92(2):313-321. doi: 10.1002/ccd.27656. Epub 2018 Jul 26.
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Congenital anomalies of the coronary arteries.冠状动脉先天性异常。
Rev Port Cardiol (Engl Ed). 2018 Apr;37(4):341-350. doi: 10.1016/j.repc.2017.09.015. Epub 2018 Feb 26.
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Anomalous origin of the circumflex coronary artery presenting with ventricular fibrillation cardiac arrest.回旋支冠状动脉异常起源伴心室颤动心脏骤停
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Coronary artery anomalies overview: The normal and the abnormal.冠状动脉异常概述：正常与异常情况
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Cardiac imaging: Part 2, normal, variant, and anomalous configurations of the coronary vasculature.心脏影像学：第 2 部分，冠状动脉血管的正常、变异和异常结构。
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SCCT guidelines for the interpretation and reporting of coronary computed tomographic angiography.冠状动脉计算机断层血管造影解读与报告的SCCT指南。
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