Situs inversus with congenital absence of left circumflex artery and a superdominant left-sided right coronary artery: A case report

Situs inversus with a coronary artery defect is an extremely rare congenital anomaly, which is often only incidentally detected during cardiac imaging studies, particularly when the patient is complaining of chest pain. We present a case study of a 37-year-old man who presented with a 3-month history of chest pain. A chest X-ray revealed dextrocardia with stomach gas in the lower right diaphragm. A CT examination showed that the right lung had 2 lobes, and the left lung had 3 lobes. This confirmed that the patient had dextrocardia with situs inversus, where the heart, organs and coronary arteries are inverted to the opposite side of the body. It is also known as a mirroring image, as the arrangement of the anatomy is unaffected. The patient''s right coronary artery was prominently inversed to the left side, while the left main coronary artery was inversed to the right side and continued toward the anterior interventricular sulcus, eventually becoming the left anterior descending (LAD) artery. The left circumflex artery was absent in the atrioventricular groove. There was also a plaque in the right-sided LAD with no significant stenosis. The patient received conservative medical therapy and had frequent follow-ups to check for potential complications.     

先天性右冠状动脉缺如一例

患者男,64岁。间歇胸闷、憋气1年,加重半个月于2009年5月入院,既往高血压病史3年,血压最高达180/90mmHg,未规律服用降压药。入院体检：血压140/70mmHg,脉搏56次/min,呼吸19次/min。     

Anomalous origin of the right vertebral artery: review of the literature and case report of right vertebral artery origin distal to the left subclavian artery.

We present the case of a 57-year-old patient who was admitted to the hospital for preoperative cerebral angiography because of an intraspinal mass at the level of C1 and C2. Angiographic examination revealed an abnormal origin of the right vertebral artery, which normally originates from the right subclavian artery. Thus, the right vertebral artery was the last branch of the supraaortic vessels. We also review herein the incidence of the various anomalous origins of the right vertebral artery in the literature and discuss their potential embryologic development and clinical significance.     

Isolated femoral osseous megalymphatics with chylous reflux: case report and review of the literature

We report here the clinical and imaging findings of marked dilatation of the intraosseous lymphatic vessels, “megalymphatics,” with chylous reflux presenting with pain and extensive lytic changes in a femoral bone of a child. Multimodality imaging findings, including radiographs, magnetic resonance imaging, ultrasound, scintigraphy and percutaneous osseous lymphangiography are described.     

Isolated agenesis of the right pulmonary artery with late manifestation of pulmonary artery hypertension

The case of a woman patient of 25 years of age with acute cardiac decompensation is presented. The chest x-ray as well as the lung scan showed the typical features of absence of the right pulmonary artery. The diagnosis was confirmed angiographically. The sudden and late onset of symptoms of pulmonary hypertension is a remarkable feature.     

原发性肺隐球菌病1例

患者女性,41岁。因＂反复头晕、视物旋转伴恶心2年,乏力1年入住心内科。原有高血压病1年。近期偶有少量咳嗽,无畏寒、发热,无消瘦、夜间盗汗。入院查体：T36.8°C,P100次/min,R 20次/min,BP 130/80mmHg。神清,精神可,浅表淋巴结未及肿大。双肺呼吸音清,未闻及干湿性罗     

先天性巨大右心房1例并文献复习

先天性巨大右心房是一种罕见的不明原因的心脏病,现将我院诊治1例分析如下。1材料与方法1.1一般资料患者男,12岁。因劳累性发作性晕厥7年,加重20天。其母亲诉患儿5岁、7岁时分别于活动后出现口唇紫绀、呼吸困难、晕厥等不适,入当地医院诊治及胸部CT检查诊断:右前纵隔囊性占位?先天性心脏病。心电图提示:心房扑动,     

Double right coronary artery diagnosed by computed tomographic angiography: A case report and systematic review of the literature

Double right coronary artery (RCA) is an extremely uncommon anomaly that is mostly detected incidentally in patients undergoing coronary angiography. It can be a benign and isolated anomaly or associated with other congenital abnormalities, mostly other coronary anomalies. Although atherosclerosis and myocardial ischemia have been frequently reported in patients with double RCA, this likely reflects that the patients were evaluated for chest pain rather than the predisposition to atherosclerosis in double RCA. Paralleling the increased awareness of this entity and the availability of non-invasive and cost-effective imaging of the coronary arteries, the diagnosis of double RCA has increased recently. Here, we present a case of double RCA diagnosed by coronary computed tomographic angiography, and provide a mini-review on the demography, anatomic variants, and clinical significance of double RCA.     

Exercise-related spontaneous coronary artery dissection: case report and literature review

BACKGROUND: Spontaneous coronary artery dissection is a rare cause of acute cardiac events and occurs most frequently in the peripartum period. Coronary artery dissection related to exercise is even more unusual, with only a few cases reported in the literature. We report a case of acute coronary artery dissection related to exercise in a 17-yr-old high school athlete, and we review the available literature on exercise-related coronary dissection. METHODS: We performed a PubMed literature search using the search terms exercise, sports, spontaneous coronary dissection, and athletics. We found seven cases of spontaneous coronary artery dissection that had occurred during intense physical exercise. Vigorous exercise can provoke acute ischemic events, but such events occur primarily in adults with atherosclerotic disease. Many of the cases reported as spontaneous coronary artery dissection are more likely atherosclerotic plaque rupture, in which cases they are not truly spontaneous. Because spontaneous coronary dissection is so rare, there are no available recommendations on how to manage young athletes with this condition. We permitted this athlete to return to limited competition, without data to support either a total restriction or even a limited restriction, with the written understanding that a recurrent event is possible but probably unlikely. In summary, spontaneous coronary artery dissection should be considered in young individuals presenting with exercise-related acute ischemic cardiac events.     

动脉导管未闭合并右肺动脉缺如一例

患儿男,1岁10个月。因有轻微活动后心率显著加快、气促,反复肺部感染入院;体格检查:发育尚可,无紫绀,气管居中,双肺呼吸音增粗,未闻音;心律齐,肺动脉瓣区明显连续性杂音;胸部X线:左肺纹理增多;心电图:窦性心动过速;心脏超声:动脉导管未闭(PDA),右室稍扩大;心血管造影:PDA=18mm×6mm,降主动脉———左肺动脉(图1,主动脉造影);右肺动脉未显影,提示右肺动脉缺如(absence ofright pulmonary artery APA),左肺动脉发育正常(图2,右室造影,导管经PDA至左肺动脉再进入右心室);肺动脉压84/36/57mmHg,左、右肺静脉发育可。遂予以PDA试封堵,用…     

Left pulmonary artery sling in the adult: Case report and review of the literature

The aberrant left pulmonary artery is a serious anomaly in neonates; in the adult it is most often an incidental finding. One case is reported, incidentally discovered in the diagnostic workup of a patient with a vertebral lytic lesion. This vascular anomaly, mimicking a mediastinal adenopathy on the chest roentgenogram, which also showed a peripheral lung malignancy, was better assessed by an esophagogram (indentation on the posterior tracheal wall as well as on the anterior esophageal wall) along with fluoroscopy which showed the lesion to be pulsating. Its thorough anatomic evaluation was allowed by computed tomography (CT), performed for the staging of the lung tumor. The latter proves the choice modality due to its capability to provide precise information on all the different structures existing in a given cross-section.     

右肺动脉异常起源于升主动脉1例

患者女,5个月,因哭闹后全身紫绀5个月入院治疗.查体:神志清晰,两肺部未听及罗音,心率130次/min,律齐,未闻及杂音,P2亢进,未触及震颤.数字式心电分析仪:窦性心动过速,左右心室肥大.胸片:肺充血,肺动脉弓突出,右心室稍增大,左第三弓饱满.MRI扫描,动脉导管未闭,肺动脉端直径8.1mm,肺动脉总干扩张,左肺动脉发育可,起源于肺动脉总干,右肺动脉异常起源于升主动脉瓣窦上方,扩张明显.诊断:右肺动脉异常起源于升主动脉,PDA,左心房,左心室扩大,室间隔缺损不能排除,建议行心血管造影检查.     

Pituicytoma: case report and literature review

Pituicytoma is a rare primary tumour of the neurohypophysis or infundibulum, which masquerades as a pituitary adenoma. We present a pituicytoma case in a 45-year-old female presenting as a focal lesion of the neurohypophysis. This case report reviews the clinical, neuroimaging and histopathological features of this rare tumour in order to understand it better.     

小儿原发性右心室黏液纤维肉瘤侵及肺动脉一例

患儿男,3岁,2009年1月28日因胸闷、气短,全身水肿1周入院.体检:神清,颜面及眼睑水肿,双下肢凹陷性水肿,下腹壁、阴囊无水肿.体重14 kg,双肺听诊未见异常,心率120次/min,心界明显扩大,胸骨左缘3～4肋间可闻及收缩期Ⅲ级吹风样杂音,肺动脉瓣第二音=主动脉瓣第二音.心电图提示:窦性心动过速,心电轴右偏,P波高尖,提示右心室扩大.     

肠系膜血管瘤1例及文献复习

目的探讨肠系膜血管瘤的MRI表现,提高对肠系膜血管瘤的认识。方法回顾性分析1例经手术证实的肠系膜血管瘤病人MRI资料并行文献复习。结果 MRI检查显示下腹部及盆腔巨大、呈扇形分布的囊实性肿块,于T_1WI、T_2WI及精准频率反转恢复序列信号混杂,其内可见多发线样分隔,呈蜂窝样改变;病变边缘于T_2WI还可见多发细小血管流空影,邻近肠管受压移位,局部肠壁与病变分界不清。结论肠系膜血管瘤的影像表现较具特异性,熟悉肠系膜解剖结构及血管瘤的特征性影像表现有助于本病的诊断,确诊需依赖病理组织学检查。