巨大的右冠状动脉动脉瘤与左心室:一种罕见的冠状动脉异常
Osama A Abdulrahman1, Malath A Alrowili2, Mohammad F Babgi3
1Department of Cardiac Surgery, Madina Cardiac Center, Madina, Saudi Arabia.
JACC. Case reports
|January 21, 2026
概括
巨大的冠状动脉动脉瘤与左心室抽是罕见的,可能导致心脏骤停. 这个案例强调了对这些复杂的血管异常的成像和以患者为中心的护理.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 血管外科 血管外科
背景情况:
- 巨型冠状动脉动脉瘤是一种罕见的血管异常,患病率<0.02%.
- 从冠状动脉瘤进入左心室 (LV) 的流非常罕见.
- 这些情况可以表现为恶性心律不整或突然心脏骤停.
研究的目的:
- 报告一例罕见的巨型冠状动脉动脉瘤与左心室囊和真正的LV动脉瘤.
- 要突出复杂的冠状动脉异常多模式成像的诊断实用性.
- 强调患者在治疗决策中的自主权的重要性.
主要方法:
- 一名65岁的男性患有高血压和疑似心肌病,出现了心室动脉冲动停止.
- 多模式成像检测发现了一个42毫米的右冠状动脉动脉瘤与LV,下LV动脉瘤和大动脉扩张.
- 一个多学科的团队讨论了手术修复和ICD安置,但患者选择了医疗管理.
主要成果:
- 患者在最初的心脏骤停中幸存下来,并经过医疗管理.
- 诊断出了右冠状动脉动脉瘤,LV,和真正的LV动脉瘤的罕见三位一体.
- 患者在稳定状态下出院,并有监测计划.
结论:
- 这一案例说明了由于冠状动脉动脉瘤,LV囊和LV动脉瘤三重体的心脏骤停的罕见表现.
- 多模式成像对于诊断这种罕见的冠状动脉异常至关重要.
- 以患者为中心的决策和尊重患者的自主权至关重要,即使它们偏离了指导方针驱动的建议.
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