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右冠状动脉起源于左前降支一例 总被引:2,自引:0,他引:2
患者男性 ,62岁。因冠心病心绞痛入院 ,冠状动脉造影发现右冠状动脉起源于左前降支中段 ,它是一种罕见的左单支冠状动脉畸形。具有潜在的危险性 相似文献
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<正>患者:男性,47岁,主因发作性胸痛2个月,加重10余天入院。体格检查:血压119/74 mmHg(1 mmHg=0.133 kPa),肺部、腹部未见明显异常。既往体格健康,有吸烟史约20年,每天约60支。2021年9月入院查心电图提示窦性心律,V4~6导联ST段压低约0.1 mV。心肌酶正常,低密度脂蛋白3.25 mmol/L。心脏彩色超声(彩超)示:左室舒张末内径4.7 cm,左室射血分数59%。入院前10 d,外院冠状动脉增强CT示:冠状动脉硬化,左冠状动脉为著,其中左冠状动脉前降支近、中段,回旋支管腔重度狭窄,右冠状动脉起源于左冠状动脉前降支近段(起源异常)。 相似文献
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右冠状动脉起源于左乏氏窦是较少见的冠脉畸形,在一组126595例连续冠脉造影病人中占136例(0.11%)[YamanakaO,HobbsRE:CathCardiovasDiag,1990,21:28~40.],既往多认为其属良性病变,无重要临床意义。然而,近年来渐有发生心肌梗塞、心绞痛、晕厥、猝死等的报道。目前认为其属潜在恶性异常。本文报告1例临床具有胸痛与心电图异常而冠脉造影无局灶病变患者,临床资料如下。患者男性,41岁,以“发作性心前区疼痛6天”为主诉入院,患者于行走时突发胸痛,向左背部放… 相似文献
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自发性冠状动脉夹层(SCAD)是一种罕见的冠状动脉病变,严重时可导致急性心肌梗死甚至猝死。尽管目前已提出了一些原因,如避孕药物的使用、先天性结缔组织发育不良综合征、马凡综合征以及结节性多动脉炎等[1-3],但真正的原因尚不清楚,且与冠心病危险因素并无重叠[1,4]。 相似文献
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患者 ,男 ,4 1岁 ,反复发作性胸痛、胸闷 2年 ,加重 1周 ,于 2 0 0 1年 5月入院。 2年前在骑车时出现心前区疼痛伴胸闷、憋气、出汗 ,休息 3~ 4min后症状自行缓解。每年发作 5~ 6次 ,发作时查心电图示窦性心动过缓 ,但无ST T改变 ,拟诊“冠心病” ,口服硝酸异山梨酯等治疗。入院前一周类似症状发作 3次。既往有高血压病史 5年 ,服降压 0号等治疗 ,血压控制良好。高血脂 4年 ,间断服用微粒化非诺贝特。吸烟 5年 ,15支 /d。入院查体 :血压 16 0 /110mmHg(1mmHg =0 133kPa) ,心脏不大 ,心率 6 6次 /min ,律齐 ,无病理… 相似文献
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<正>病例资料:患者女性,69岁,因反复心绞痛药物治疗无效,于2012年9月26日入院。有高血压病史20余年,无糖尿病,血脂正常。入院后第三天行冠状动脉造影示:左主干开口狭窄40%,前降支近中段弥散性狭窄,最重处狭窄95%,第一对角支开口狭窄80%,右冠状动脉呈弥散性不规则病变(图1)。根据造影结果,决定介入干预前降支。前降支介入治疗过程:选择右股动脉入路,穿刺成功后,置入6F动脉鞘,肝素9 000U鞘入,选用6F Judkins指引导管,经指引导管送入两根BMW指引导丝,其中一根置于第一对角支保护,另一根通 相似文献
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Anomalous origin of the main coronary arteries from the aorta is rare. We report a case with a single coronary artery from the right sinus of Valsalva associated with atherosclerosis.The patient was treated with a coronary artery bypass procedure: left internal mammary artery (LIMA) to the left anterior descending artery (LAD), right internal mammary artery (RIMA) to the right coronary artery (RCA).The postoperative course was uneventful. 相似文献
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T Seo Y Ikeda H Fujita T Hayashi K Kawaguchi C Kotake T Toda K Kobayashi H Tsujino Y Takeuchi 《呼吸と循環》1991,39(10):1043-1047
A 56-year-old man visited our hospital for further examination of resting electrocardiographic abnormality. Positive exercise stress resulted in mild chest discomfort and 1.5 mm ST depression in II.III.aVF leads. Myocardial imaging perfusion with thallium-201 was normal and an anomalous origin of the left circumflex coronary artery from the right aortic sinus was observed by coronary angiography. MRI showed that the vessel running behind the aorta was connected to the right Valsalva's sinus. Furthermore, transesophageal echocardiography revealed that the vessel connected to the lateral wall of the left ventricle was running from the right Valsalva's sinus between the aorta and left atrium. The above results indicated that this vessel was the left circumflex artery. Although myocardial infarction or sudden death in patients with coronary anomaly has been discussed, the mechanism is still unknown. The present case is a rare one in which the anatomical relation between the anomalous coronary and the great vessels was directly detectable by transesophageal echocardiography. Transesophageal echocardiography is useful for the assessment of this type of coronary anomaly. 相似文献
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Ronald F. Sher Abdulmassih S. Iskandrian Demetrios Kimbiris Charles E. Bemis 《Catheterization and cardiovascular interventions》1978,4(4):413-417
We present the clinical, angiographic and surgical findings in a 63-year-old man with anomalous origin of the left main coronary artery from the right sinus of valsalva. The course of the left main artery was abnormal in that it passed between the aorta and the pulmonary artery; in addition, there was obstructive disease involving the left main coronary artery. The association of these two entities in this age group is unusual. 相似文献
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Ozcan Ozeke; Omac Tufekcioglu; Bilal Geyik; Ali Yildiz; Mucahit Yetim 《European journal of echocardiography》2005,6(1):64
A 32-year-old man, admitted for inguinal hernia repair, wasreferred for preoperative 相似文献
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A 6-year-old child presented with left sinus of Valsalva aneurysm opening in right atrium. Origin of sinus of Valsalva from left aortic sinus and its opening into right atrium is extremely rare. The anomaly was corrected surgically by patch closure at the aortic end. Follow-up echocardiography did not reveal any residual shunt in right atrium. 相似文献
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A case is reported of a right sinus of Valsalva aneurysm rupture into the right ventricle during vaginal delivery in a 34-year-old healthy woman in her third pregnancy. Pregnancy was carried to term and a healthy baby was delivered vaginally. On day 7 following vaginal delivery she was admitted to hospital for dyspnea and cough, with clinical signs of severe heart failure. The diagnosis of the right sinus of Valsalva aneurysm rupture into the right ventricle was established by transthoracic and transesophageal echocardiography. Clinical recognition and early echocardiographic diagnosis followed by immediate surgical repair proved lifesaving in our patient. 相似文献
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Hemery Y Richard P Belaouchi F Heloire F Monsegu J Varenne O Spaulding C 《Archives des maladies du coeur et des vaisseaux》2000,93(12):1565-1569
The authors report the case of a patient undergoing coronary angiography for a lateral myocardial infarction related with atherosclerosic lesions but associated with a rare anomalous origin of all three coronary arteries from separate ostia in the right sinus of Valsalva. Anomalous origin of coronary arteries from the opposite sinus are potentially serious especially among young subjects and when a vessel runs between the aorta and pulmonary artery. Clinical presentation, angiographic diagnostic and treatment strategies are discussed. 相似文献