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一名有症状的成年患者的肺动脉起源异常左冠状动脉:病例报告

Anomalous left coronary artery from the pulmonary artery in a symptomatic adult: a case report.

作者信息

Kc Sharada, Karki Parag, Khatiwada Abhikanta, Pokhrel Saroj

机构信息

Department of Internal Medicine, NAIHS.

Department of Radiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.

出版信息

Ann Med Surg (Lond). 2024 Aug 8;86(9):5622-5626. doi: 10.1097/MS9.0000000000002451. eCollection 2024 Sep.

Abstract

INTRODUCTION

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. While only a few of those born with this anomaly survive into adulthood, it becomes an extremely rare diagnosis in adults.

CASE PRESENTATION

Here, the authors present a case of ALCAPA in a symptomatic adult female with angina and palpitations that was repeatedly missed on transthoracic echocardiogram.

CLINICAL DISCUSSION

The adult type of ALCAPA is often missed due to non-specific changes in electrocardiogram, leading to reluctance for angiography. Therefore, identifying abnormal coronaries in echocardiogram is crucial.

CONCLUSION

It is essential to consider anomalous coronary arteries as a differential diagnosis in patients with chest pain, despite their rarity. This case report highlights the role of various cardiac imaging modalities in improving the diagnostic yield of ALCAPA.

摘要

引言

左冠状动脉起源于肺动脉(ALCAPA)是一种罕见的先天性异常。虽然患有这种异常的人中只有少数能存活到成年,但在成年人中这成为一种极其罕见的诊断。

病例报告

在此,作者报告一例有症状的成年女性ALCAPA病例,该患者有胸痛和心悸症状,经胸超声心动图多次漏诊。

临床讨论

成人型ALCAPA常因心电图非特异性改变而漏诊,导致不愿进行血管造影。因此,在超声心动图中识别异常冠状动脉至关重要。

结论

尽管冠状动脉异常罕见,但在胸痛患者中必须将其作为鉴别诊断考虑。本病例报告强调了各种心脏成像方式在提高ALCAPA诊断率方面的作用。

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