Janata K, Regele H, Bankier A A, Domanovits H, Kürkciyan I, Sterz F, Laggner A N
Department of Emergency Medicine, General Hospital of Vienna, University of Vienna, Austria.
Resuscitation. 1994 Jul;28(1):37-42. doi: 10.1016/0300-9572(94)90052-3.
Anomalies of coronary artery origin can be of little clinical significance and only an incidental autopsy finding. However recent case reports have shown that a wide range of potential pathologic alterations of congenital coronary anomalies are associated with clinical symptoms and exercise related sudden death. We describe the case of a 16-year-old girl who sustained a cardiac arrest and died after cardiopulmonary resuscitation (CPR) of intractable cardiogenic shock. The sporty and previously healthy girl suddenly fainted after swimming in a tributary of the Danube. Autopsy revealed an anomalous origin of the left coronary artery from the anterior sinus of Valsalva and its course between aorta and pulmonary artery. The cause of this anomalous origin and possible mechanism for sudden death is discussed. We conclude that this congenital anomaly should be considered in cases of major cardiac events in young people.
冠状动脉起源异常可能临床意义不大，仅为尸检时偶然发现。然而，最近的病例报告显示，先天性冠状动脉异常存在广泛的潜在病理改变，与临床症状及运动相关的猝死有关。我们描述了一名16岁女孩的病例，她在对顽固性心源性休克进行心肺复苏（CPR）后心脏骤停并死亡。这个热爱运动且此前健康的女孩在多瑙河一条支流游泳后突然晕倒。尸检显示左冠状动脉起源于瓦尔萨尔瓦窦前窦，走行于主动脉和肺动脉之间。本文讨论了这种异常起源的原因及猝死的可能机制。我们得出结论，对于年轻人发生的重大心脏事件，应考虑这种先天性异常。
