跑步机上的心脏骤停

Q4 Medicine

JACC. Case reports Pub Date : 2025-10-08 DOI:10.1016/j.jaccas.2025.105334

Thomas Diamond MD, Cesar Joel Benites-Moya MD, Abhinav Karan MD, Khalid Shakfeh MD, Anvit Reddy MD, Fabiana Rollini MD, Ali Zgheib MD

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引用次数: 0

摘要

一名28岁的健康女性在跑步机上跑步时晕倒，没有已知的病史或疾病。最初的血管造影提示左主干自发性冠状动脉剥离（SCAD），但冠状动脉计算机断层血管造影（CCTA）显示左主干冠状动脉异常，起源于右窦，伴壁内动脉间程。手术矫正。本病例展示了一名年轻患者在运动过程中出现心脏骤停的诊断挑战，最初被认为是SCAD；CCTA进一步评估未发现SCAD的证据。影像学显示左冠状动脉主动脉起源于右冠状动脉窦，并伴有动脉间和壁内病变，这是一种与年轻时心源性猝死相关的高危异常。左冠状动脉主干的异常路线是罕见的，与心源性猝死有关，特别是在年轻人中。CCTA是诊断的金标准，手术干预是最终的治疗方法。

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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Sudden Cardiac Arrest on the Treadmill

Background

A 28-year-old healthy woman collapsed while running on a treadmill, with no known past medical history or conditions.

Case Summary

Initial angiography suggested left main spontaneous coronary artery dissection (SCAD), but coronary computed tomography angiography (CCTA) revealed an anomalous left main coronary artery arising from the right sinus with an intramural interarterial course. Surgical correction was performed.

Discussion

This case demonstrates the diagnostic challenges in a young patient presenting with sudden cardiac arrest during exertion, initially presumed to be SCAD; further evaluation with CCTA revealed no evidence of SCAD. The imaging uncovered an anomalous origin of the left main coronary artery from the right coronary sinus with an interarterial and intramural course, which is a high-risk anomaly associated with sudden cardiac death at a young age.

Take-Home Messages

Anomalous courses of the left main coronary artery are rare and associated with sudden cardiac death, particularly in young individuals. CCTA is the gold standard for diagnosis, with surgical intervention being the definitive treatment.

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