Lethor J P, Marcon F, Bosser G, Marie P Y, Lucron H, Worms A M
Service de cardiologie infantile, hôpital d'Enfants de Brabois, Vandoeuvre-lès Nancy.
Arch Mal Coeur Vaiss. 1996 May;89(5):637-9.
During a routine medical check-up, a pathological electrocardiogram was recorded in an asymptomatic 6 year old girl. The demonstration of coronary insufficiency by exercise stress testing and sestamib myocardio-scintigraphy led to the diagnosis of an anomalous origin of the left coronary artery. This vessel arose from the right coronary sinus and continued anteriorly to the main coronary artery. The data of the literature suggest that the risk of sudden death and of coronary insufficiency is associated with the passage of the left coronary artery between the aorta and pulmonary artery. The authors describe the anomalous origin of the left coronary artery and its trajectory with respect to the great vessels by echocardiography, using a high frequency transducer. The anterior direction of the left coronary artery in front of the main pulmonary artery may lead to ischaemia on effort even without stenosis at coronary angiography. Echocardiography may therefore be useful in children with positive exercise stress tests for diagnosing anomalous coronary vessels and their relationship with respect to the great vessels.
在一次常规体检中，一名6岁无症状女孩记录到病理性心电图。运动负荷试验和锝-99m甲氧基异丁基异腈心肌闪烁扫描显示冠状动脉供血不足，从而诊断为左冠状动脉起源异常。该血管起自右冠状动脉窦，向前延续至主冠状动脉。文献数据表明，猝死和冠状动脉供血不足的风险与左冠状动脉在主动脉和肺动脉之间的走行有关。作者使用高频探头，通过超声心动图描述了左冠状动脉的异常起源及其相对于大血管的走行轨迹。即使冠状动脉造影无狭窄，左冠状动脉在主肺动脉前方的向前走行也可能导致运动时缺血。因此，超声心动图对于运动负荷试验阳性的儿童诊断异常冠状动脉血管及其与大血管的关系可能有用。
