Fukuda I, Ijima H, Itoh T, Iriyama T, Maeta H, Okamura K, Mitsui T, Hori M
Jpn Heart J. 1983 Nov;24(6):1007-15. doi: 10.1536/ihj.24.1007.
Aneurysm of the coronary artery associated with aortitis syndrome is extremely rare. This is a case report of a left coronary artery aneurysm associated with aortitis syndrome. The patient was a 47-year-old woman who complained of palpitation and dizziness on exertion. Aortogram revealed occlusion of the arch vessels, infrarenal aortic stenosis, and a fusiform aneurysm of the left coronary artery. There was neither an intraluminal thrombus nor occlusive changes in the coronary arteries. Severe systolic hypertension nearing 300 mmHg was present in the ascending aorta. Severe hypertension and direct extension of inflammation to the coronary artery seemed to be important factors for the formation of the aneurysm. To resolve the severe hypertension, a bypass operation between the ascending aorta and the abdominal aorta distal to the stenosis was performed. The postoperative course was uneventful and blood pressure was reduced.
与大动脉炎综合征相关的冠状动脉瘤极为罕见。本文报告一例与大动脉炎综合征相关的左冠状动脉瘤病例。患者为47岁女性，主诉劳力时心悸、头晕。主动脉造影显示主动脉弓血管闭塞、肾下腹主动脉狭窄以及左冠状动脉梭形动脉瘤。冠状动脉内既无腔内血栓形成，也无闭塞性改变。升主动脉存在接近300 mmHg的重度收缩期高血压。重度高血压以及炎症直接蔓延至冠状动脉似乎是动脉瘤形成的重要因素。为解决重度高血压问题，在升主动脉与狭窄远端的腹主动脉之间进行了搭桥手术。术后病程顺利，血压下降。
