Akaike M, Nishiuchi T, Ohara A, Okauchi Y, Kawai H, Saito S
First Department of Internal Medicine, School of Medicine, University of Tokushima.
Kokyu To Junkan. 1993 Sep;41(9):905-9.
A 54-year-old man was admitted to our hospital because of exertional dyspnea. A second heart sound with fixed splitting and a systolic ejection murmur along the left sternal border was audible. The chest roentgenogram showed increased pulmonary vascularity, and the electrocardiogram showed incomplete right bundle branch block. Two-dimensional echocardiography in the parasternal view demonstrated a partition defect between the left atrium and the coronary sinus. Furthermore, transesophageal echocardiography revealed a left-to-right shunt flow into the coronary sinus through the defect. At these points, the patient was diagnosed as having a partially unroofed mid-portion of the coronary sinus. Unroofed coronary sinus is a cardiac anomaly rarely diagnosed prior to surgical operation. Two-dimensional echocardiography, especially transesophageal echocardiography, is useful for the preoperative diagnosis of unroofed coronary sinus.
一名54岁男性因劳力性呼吸困难入院。可闻及第二心音固定分裂以及沿胸骨左缘的收缩期喷射性杂音。胸部X线片显示肺血管增多，心电图显示不完全性右束支传导阻滞。胸骨旁切面二维超声心动图显示左心房与冠状窦之间存在间隔缺损。此外，经食管超声心动图显示有分流血流经缺损处从左向右流入冠状窦。基于上述情况，该患者被诊断为冠状窦中部部分无顶。冠状窦无顶是一种在手术前很少被诊断出的心脏异常。二维超声心动图，尤其是经食管超声心动图，对冠状窦无顶的术前诊断很有用。
