在冠状动脉开口的动态模仿左侧主疾病:一种罕见的冠状动脉阻塞原因
1Department of Cardiology, Tokyo Nippori Tanno Heart Clinic, Tokyo, Japan; Department of Cardiology, Saitama Medical University, International Medical Center, Saitama, Japan.
JACC. Case reports
|March 3, 2026
概括
冠状动脉骨状脊柱是动态冠状动脉阻塞的罕见原因,模仿左主冠状动脉疾病. 早期识别和干预对于预防严重缺血和死亡至关重要.
科学领域:
- 心脏病学 心脏病学
- 解剖学变种 解剖学变种
- 干预心脏病学 干预心脏病学
背景情况:
- 冠状动脉骨状脊柱是不常见的解剖学变异.
- 这些结构可以动态阻碍冠状动脉血流.
- 他们经常表现出类似于左主冠状动脉疾病的症状.
研究的目的:
- 描述一种由冠状动脉骨状脊柱引起的急性冠状动脉综合征病例.
- 突出与这种罕见疾病相关的诊断和治疗挑战.
- 强调早期诊断的重要性,以改善患者的治疗结果.
主要方法:
- 一个39岁的男性出现急性冠状动脉综合征的病例报告.
- 诊断冠状动脉血管学评估冠状动脉解剖和流动.
- 穿皮冠状动脉干预 (在左冠状动脉骨部部署支架).
- 尸体解剖证实了解剖学诊断.
主要成果:
- 冠状动脉扫描显示左冠状动脉骨上有一个移动的,类似门的,没有固定的狭窄.
- 肌心缺血,最初由动脉内气球支恶化,在左主冠状动脉骨干支后得到解决.
- 尽管最初情况有所改善,但该患者经历了耐火性心室低心率并死亡;尸检证实了冠状动脉骨状脊.
结论:
- 骨脊的透气压缩可以导致关键的冠状动脉阻塞和缺血.
- 这甚至可以发生在中度动脉样硬化存在的情况下.
- 及时识别和治疗冠状动脉骨类脊是预防致命结果的必要条件.
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