右冠状动脉-上腔静脉瘘并巨大上腔静脉瘤超声表现1例

患者因“胸痛”于外院行超声心动图诊断：“右冠状动脉-左房瘘”,经我院行系列影像学检查明确诊断：右冠状动脉-上腔静脉瘘,上腔静脉呈瘤样扩张。经冠状动脉造影证实,行瘘口封堵术,术后经胸超声心动图显示无残余分流。院外检查者误把上腔静脉瘤视作左房、未扫查到上腔静脉瘤样扩张。对于冠状动脉瘘,需耐心追踪异常血流路径,仔细辨认典型解剖结构,多切面扫查,减少漏诊、误诊。

Ultrasound manifestation of right coronary artery-superior vena cava fistula complicated with giant superior vena cava aneurysm: a case report

The patient was diagnosed by echocardiography in a foreign hospital due to "chest pain": "right coronary artery-left atrial fistula", and a series of imaging examinations in our hospital confirmed the diagnosis: right coronary artery-superior vena cava fistula, with tumor-like expansion of the superior vena cava . Percutaneous coronary angiography confirmed the fistula closure, and postoperative transthoracic echocardiography showed no residual shunt. The out-of-hospital examiners mistakenly regarded the superior vena cava aneurysm as the left atrium, and did not scan the superior vena cava aneurysmal dilatation. For coronary fistula, it is necessary to patiently track the abnormal blood flow path, carefully identify the typical anatomical structure, and perform multi-section scanning to reduce missed diagnosis and misdiagnosis.