右冠状动脉起源异常患者发生左冠状动脉痉挛致胸痛1例  

Chest pain caused by left coronary artery spasm in a patient with anomalous origin of right coronary artery

作　　者：曹园园 罗小岚[1] 刘启明[1] 周胜华[1] CAO Yuanyuan;LUO Xiaolan;LIU Qiming;ZHOU Shenghua(Department of Cardiovascular Medicine,Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院心血管内科,长沙410011

出　　处：《中南大学学报（医学版）》2022年第5期679-684,共6页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(81800276);湖南省自然科学基金(2018JJ3760)。

摘　　要：冠状动脉起源异常是中青年患者胸痛、晕厥甚至猝死的罕见但重要原因。中南大学湘雅二医院心血管内科于2021年2月18日收治1例右冠状动脉起源异常的患者,因左冠状动脉前降支发生痉挛引起严重狭窄导致胸痛。该患者反复自发胸痛伴前壁ST段和T波改变,通过冠状动脉造影证实为左冠状动脉痉挛,应用地尔硫卓及单硝酸异山梨酯联合治疗后患者胸痛得到控制。出院后随访3个月,患者胸痛未再发作。Anomalous origin of coronary artery is rare and important reason of chest pain,syncope,and sudden death in young and middle-aged patients.This case reported a patient with interarterial anomalous right coronary artery and chest pain,which was confirmed to be the result of severe vasospasm of the proximal left anterior descending artery.The patient had reoccurred spontaneous chest pain and the dynamic ST segment and T wave changes at anterior walls.Coronary angiography confirmed left coronary artery spasm.Chest pain was controlled by diltiazem and isosorbide mononitrate.During 3 months of follow-up after discharge,the patient did not have chest pain anymore.

关 键 词：冠状动脉起源异常 冠状动脉痉挛 胸痛 血管内超声 

分 类 号：R543.3[医药卫生—心血管疾病]