临床儿科杂志 ›› 2018, Vol. 36 ›› Issue (7): 493-.doi: 10.3969/j.issn.1000-3606.2018.07.004

• 心血管疾病专栏 • 上一篇    下一篇

儿童左冠状动脉异常起源于右冠窦 1 例报告

赵坚, 张永为, 李筠, 肖婷婷, 谢利剑, 王健怡, 姜逊渭   

  1. 上海市儿童医院 上海交通大学附属儿童医院心内科(上海 200062)
  • 收稿日期:2018-07-15 出版日期:2018-07-15 发布日期:2018-07-15
  • 通讯作者: 张永为  E-mail:zhangyw@ shchildren.com.cn

Anomalous origin of left coronary artery from right coronary sinus in children: a case report and literature review 

ZHAO Jian, ZHANG Yongwei, LI Yun, XIAO Tingting, XIE Lijian, WANG Jianyi, JIANG Xunwei   

  1. Department of Cardiology, Children’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200062, China
  • Received:2018-07-15 Online:2018-07-15 Published:2018-07-15

摘要: 目的 探讨冠状动脉异常起源主动脉的临床意义。方法 回顾分析1例疾病初期误诊为暴发性心肌炎、最终 诊断为冠状动脉异常起源主动脉患儿的临床资料,并复习相关文献。结果 患儿,女, 9岁,运动后出现晕厥;心肌酶谱增 高,肌钙蛋白阳性;心电图提示心肌缺血改变;心脏超声提示心功能下降。经积极治疗后,冠脉CT造影提示左冠状动脉起 源于右冠窦。结论 冠状动脉异常起源主动脉为临床较少见的心血管畸形,部分存在潜在的猝死风险。

Abstract:  Objective To explore the clinical significance of anomalous origin of coronary artery from the aorta. Methods The clinical data of a case of anomalous origin of coronary artery from the aorta which was misdiagnosed as fulminant myocarditis in the early stage of the disease were retrospectively analyzed and relative literature were reviewed. Results A 9-year-old girl had syncope after exercise and was found to have the significant elevation of myocardial enzyme and troponin. Electrocardiogram showed myocardial ischemia changes and the cardiac ultrasonography indicated decreased cardiac function. It was diagnosed as the left coronary artery from the right coronary sinus by the CT angiography. Conclusion The anomalous origin of coronary artery is a rare cardiovascular malformation. Some patients have a potential risk of sudden death.