Ifuku Toshinobu, Nakatani Keigo, Ueno Kentaro, Yamashita Naoto, Imoto Yutaka
Department of Pediatrics, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Case Rep Pediatr. 2024 Feb 1;2024:6390066. doi: 10.1155/2024/6390066. eCollection 2024.
Syncope is a common symptom in children, many of which are benign and do not require treatment. Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital malformation but can be a risk for serious cardiovascular events, including sudden death as well as cardiogenic syncope. . We describe the case of a 14-year-old boy who suffered an initial syncope and afebrile seizure during a soccer game. A detailed medical history and imaging studies led to the diagnosis of the anomalous aortic origin of the left main coronary artery with an intramural course (AAOLCA-IM).
Symptomatic AAOLCA-IM has the highest risk of sudden death among AAOCA, and surgical repair may be performed. Onset during exercise or preceding chest symptoms are suspicious signs of cardiogenic syncope and should be considered for cardiovascular imaging evaluation.
晕厥是儿童常见症状，其中许多是良性的，无需治疗。冠状动脉异常起源于主动脉（AAOCA）是一种罕见的先天性畸形，但可能是严重心血管事件的风险因素，包括猝死以及心源性晕厥。我们描述了一名14岁男孩的病例，他在足球比赛期间首次出现晕厥和无热惊厥。详细的病史和影像学检查导致诊断为左主冠状动脉异常起源于主动脉且走行于壁内（AAOLCA-IM）。
有症状的AAOLCA-IM在AAOCA中猝死风险最高，可能需要进行手术修复。运动期间发作或之前出现胸部症状是心源性晕厥的可疑迹象，应考虑进行心血管影像学评估。
