冠状动脉瘘误诊冠心病12例分析并文献复习

目的:探讨误诊为冠心病的冠状动脉瘘病例的临床特点、误诊原因。方法:回顾性分析12例误诊为冠心病的冠状动脉瘘患者的临床资料。结果:5例经超声诊断,12例均经冠脉造影确诊。瘘来自左冠脉9例(75％);来自右冠脉1例;来自双侧冠脉2例。入院均误诊为冠心病。8例行手术治疗,手术均成功,预后均良好。结论:中老年冠状动脉瘘患者易误诊为冠心病。超声心动图、病史、体格检查对鉴别诊断有价值,心血管造影可确诊。冠状动脉瘘手术预后好。

Analysis of 12 Cases of Coronary Fistulas Misdiagnosed as Coronary Heart Disease and Literature Review

Objective:To study the clinical characteristic and reasons of coronary fistulas misdiagnosed as coronary heart disease (CHD). Methods: Twelve cases of coronary fistulas misdiagnosed as CHD were retrospectively analyzed. Re- sults: 5 cases were diagnosed by echocardiogram and all determinate diagnosed by angiocardiography. 9 (75%) cases of coronary fistulas were from left coronary artery, 1 case from right coronary artery, and 2 cases from both. 12 patients were all misdiagnosed as coronary artery disease before entering hospital. 8 patients were operated successfully with good prognosis. Conclusion:Coronary fistulas in middle-aged or aged patients were frequently misdiagnosed as CHD. E- chocardiogram, history, and physical examination are helpful in differential diagnosis. Angiocardiography can make final diagnosis. The prognosis in the patients after operation are good.