Corcoran Jason, Barbarawi Mahmoud
Research, Alabama College of Osteopathic Medicine, Dothan, USA.
Cardiology, University of Connecticut School of Medicine, Farmington, USA.
Cureus. 2023 Jul 12;15(7):e41773. doi: 10.7759/cureus.41773. eCollection 2023 Jul.
An anomalous coronary artery (ACA) is a congenital malformation or variation where one or both coronary arteries have an abnormal origin. This condition has been associated with a high risk of adverse cardiac events, including sudden cardiac death. Our patient initially presented nine years before the diagnosis of the ACA with anginal chest pain on exertion. The patient had positive nuclear stress with both ST depressions and ST elevations, as well as transient ischemic dilatation of 1.36. A coronary artery angiogram revealed an anomalous left coronary artery originating from the right coronary sinus. The distal anatomy was determined with coronary computed tomography angiography (CCTA), which showed an interarterial course. The patient underwent coronary artery bypass surgery following CCTA.
异常冠状动脉（ACA）是一种先天性畸形或变异，其中一条或两条冠状动脉起源异常。这种情况与包括心源性猝死在内的不良心脏事件的高风险相关。我们的患者在诊断为ACA之前九年首次出现劳力性心绞痛胸痛。患者核素心肌负荷试验结果为阳性，伴有ST段压低和ST段抬高，以及1.36的短暂性缺血性扩张。冠状动脉造影显示左冠状动脉起源于右冠状窦异常。通过冠状动脉计算机断层扫描血管造影（CCTA）确定了远端解剖结构，显示为动脉间走行。患者在CCTA后接受了冠状动脉搭桥手术。
