Wojtyna W, Wiese K H, Strauss P, Walter J
Z Kardiol. 1982 Jan;71(2):106-11.
We report about the sudden death of a 45-year-old woman with anomalous origin of both coronary arteries from a single ostium in the right sinus of Valsalva, the left coronary artery running between the aorta and the pulmonary trunk. The clinical picture was that of Prinzmetal's form of variant angina, and it preceded death of inferior myocardial infarction. Coronary spasm and the anatomical anomaly were demonstrated by coronary angiography. There was no atheromatous plaque or other obstructive lesion in the dominant right coronary artery which could have explained the inferior myocardial infarction seen at autopsy. This is the first detailed report in which this rare coronary anomaly has been associated with Prinzmetal's variant angina. The demonstration of spasm in the dominant coronary artery and of an infarct in that part of the myocardium supplied by it in the absence of any anatomical obstruction suggests that this patient's death resulted from coronary spasm.
我们报告了一名45岁女性的猝死病例，其双侧冠状动脉均起源于右冠窦的单一开口，左冠状动脉走行于主动脉和肺动脉干之间。临床表现为变异型心绞痛（Prinzmetal型），且在死于下壁心肌梗死之前就已出现该症状。冠状动脉造影显示了冠状动脉痉挛和解剖学异常。尸检所见的右冠状动脉为优势动脉，未见动脉粥样硬化斑块或其他阻塞性病变，无法解释下壁心肌梗死的发生。这是首例将这种罕见的冠状动脉异常与变异型心绞痛（Prinzmetal型）相关联的详细报告。在优势冠状动脉中显示出痉挛，且在其供血的心肌部位出现梗死，而不存在任何解剖学阻塞，这表明该患者的死亡是由冠状动脉痉挛所致。
