Sørgaard Mathias Holm, Kofoed Klaus Fuglsang, Abdulla Jawdat
Department of cardiology, Gentofte Hospital, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark.
Department of cardiology, The Heart Centre, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Eur Heart J Case Rep. 2023 Mar 1;7(3):ytad113. doi: 10.1093/ehjcr/ytad113. eCollection 2023 Mar.
An anomalous origin of the right coronary artery from pulmonary artery (ARCAPA) is a very rare coronary anomaly.
A 56-year-old man, presenting haemodynamically unstable due to very rapid atrial fibrillation, was found to have ARCAPA by coronary computed tomography angiography. He had normal left ventricular ejection fraction and without reversible ischaemia on an adenosine stress rubidium positron emission tomography. He was treated solely with betablockers and has been well since.
Numerous case reports on ARCAPA have previously been published, but no previous reports have found rapid atrial fibrillation to be the primary symptom of presentation. Current evidence level concerning the treatment is low; nevertheless, surgical intervention should always be considered to prevent sudden cardiac death. The patient in this case was offered surgical intervention but declined.
右冠状动脉起源于肺动脉（ARCAPA）是一种非常罕见的冠状动脉异常。
一名56岁男性因快速房颤导致血流动力学不稳定，经冠状动脉计算机断层血管造影发现患有ARCAPA。他的左心室射血分数正常，腺苷负荷铷正电子发射断层扫描未发现可逆性缺血。他仅接受了β受体阻滞剂治疗，此后情况良好。
此前已发表了许多关于ARCAPA的病例报告，但此前没有报告发现快速房颤是主要的临床表现。目前关于治疗的证据水平较低；然而，应始终考虑手术干预以预防心源性猝死。该病例的患者被提供了手术干预，但拒绝了。
