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冠状动脉瘤:支持治疗选择的临床病例报告及文献综述

Coronary Artery Aneurysms: A Clinical Case Report and Literature Review Supporting Therapeutic Choices.

作者信息

Sannino Michele, Nicolai Matteo, Infusino Fabio, Giulio Luciani, Usai Tommaso Leo, Biscotti Giovanni, Azzarri Alessandro, De Angelis D'Ossat Marina, Calcagno Sergio, Calcagno Simone

机构信息

Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy.

Radiodiagnostic Unit, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy.

出版信息

J Clin Med. 2024 Sep 10;13(18):5348. doi: 10.3390/jcm13185348.

Abstract

Coronary artery aneurysms (CAAs) are uncommon but significant cardiovascular abnormalities characterized by an abnormal increase in vascular diameter. CAAs are classified based on their shape as either saccular or fusiform, and their causes can range from atherosclerosis, Kawasaki disease, to congenital and iatrogenic factors. CAAs often present asymptomatically, but when symptoms occur, they can include angina, myocardial infarction, or even sudden cardiac death due to intravascular thrombosis involving the CAA. Diagnosis is typically confirmed through coronary angiography, though CT and other imaging techniques can provide additional details. The management of CAAs is variable depending on their size, location, and the presence of symptoms or complications. Treatment options include medical therapy, percutaneous coronary intervention (PCI), or surgical approaches. In this paper, we describe the case report of a 79-year-old male who presented with palpitations and was diagnosed with a right coronary artery aneurysm, and a review of the literature is delineated, underscoring the importance of individualized treatment strategies for CAAs.

摘要

冠状动脉瘤(CAAs)并不常见,但却是重要的心血管异常,其特征为血管直径异常增大。冠状动脉瘤根据其形状可分为囊状或梭形,其病因范围从动脉粥样硬化、川崎病到先天性和医源性因素。冠状动脉瘤通常无症状,但出现症状时,可包括心绞痛、心肌梗死,甚至因涉及冠状动脉瘤的血管内血栓形成导致的心源性猝死。诊断通常通过冠状动脉造影来确认,不过CT和其他成像技术可提供更多细节。冠状动脉瘤的管理因瘤体大小、位置以及症状或并发症的存在情况而异。治疗选择包括药物治疗、经皮冠状动脉介入治疗(PCI)或手术方法。在本文中,我们描述了一名79岁男性因心悸就诊并被诊断为右冠状动脉瘤的病例报告,并对文献进行了综述,强调了冠状动脉瘤个体化治疗策略的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29cf/11432381/d5820455d3fa/jcm-13-05348-g001.jpg

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