右冠状动脉的高起飞通过心声回声:正常变体还是更多的东西?
Ashley S Cooley1,2, Curt G DeGroff1, Jennifer Co-Vu1
1Congenital Heart Center, Division of Pediatric Cardiology, Department of Pediatrics, University of Florida, Gainesville, FL, USA.
心声图可能会误解右冠状动脉的高起飞. 进一步调查至关重要,因为这一发现可能表明危险的室内课程需要风险分层和治疗.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 右冠状动脉 (RCA) 的高起飞通常被认为是回声心脏图的正常变体.
- 然而,一些病例可能代表具有高风险特征的异常冠状动脉起源.
研究的目的:
- 调查回声心脏图是否怀疑高RCA起飞表明异常冠状动脉与潜在的恶性内腔过程.
- 评估在这种情况下是否需要进一步调查.
主要方法:
- 62名患有冠状动脉异常或对其存在担忧的患者的回顾性审查.
- 通过心声图识别24名最初被诊断为高RCA起飞的患者.
- 其中20名患者进行了计算机断层扫描血管造影 (CTA) 验证.
主要成果:
- 在24名患者中,9名患有异常的RCA起源于左冠状动脉鼻 (3) 或刚好在左冠状动脉鼻上方 (6).
- 在这9名患者中,有6名患者表现出室内治疗过程.
- 在左冠状动脉鼻腔上方的高起飞与与右冠状动脉鼻腔 (0/6) 上方相比,与内腔过程 (6/9) 的更高可能性有关.
结论:
- 心声学可以不准确地确定冠状动脉的起源和轨迹.
- 准确的诊断对于风险分层和治疗决策至关重要.
- 疑似高RCA起飞的患者在心声回声仪上需要额外评估潜在的恶性内腔疗程.
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