多模态成像指导脑内L-AAOCA的决策

Q4 Medicine

JACC. Case reports Pub Date : 2025-06-25 DOI:10.1016/j.jaccas.2025.104014

Joseph Burns MD , Lindsay F. Eilers MD , Stephen J. Dolgner MD , Edward J. Hickey MD , Silvana Molossi MD, PhD

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引用次数: 0

摘要

背景：先天性冠状动脉异常是一类罕见的先天性心脏病，具有心源性猝死的相关风险。对于有脑室内病程的受影响患者的评估和管理数据缺乏。病例摘要：一名27岁的女性被发现有一个单一的冠状动脉干起源于右窦，并有一个2.7厘米的左冠状动脉主干。她接受了应激性心脏磁共振和导管插入术，以评估手术修复前的诱导性缺血。她的康复很顺利，至今没有任何症状。先天性冠状动脉异常的处理需要详尽的评估。需要进一步的研究来确定理想的检查、适应症、干预的时机以及医疗管理在改善症状方面的效果。先天性冠状动脉异常是一种罕见但后果严重的胸痛病因。这种诊断需要多模态成像来为决策提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Multimodal Imaging Directs Decision Making in Intraseptal L-AAOCA

Background

Congenital coronary artery abnormalities represent an uncommon class of congenital heart disease with an associated risk of sudden cardiac death. There is a paucity of data for the evaluation and management of affected patients with an intraseptal course.

Case Summary

A 27-year-old woman was found to have a single coronary trunk arising from the right sinus with a 2.7 cm intraseptal course of the left main coronary artery. She underwent stress cardiac magnetic resonance and catheterization, to assess for inducible ischemia before surgical repair with transconal unroofing. Her recovery was uneventful, and she remains free of symptoms.

Discussion

Management of congenital coronary artery anomalies requires an exhaustive evaluation. Further studies are warranted to define the ideal work-up, indication, and timing of intervention and the efficacy of medical management in improving symptoms.

Take-Home Messages

Congenital coronary anomalies represent a rare but consequential cause of exertional chest pain. This diagnosis requires multimodal imaging to inform decision making.

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