左冠狀動脈之源於主肺動脈之雙相超音波心圖及心臟血管攝影所見―一病例報告―

Angiocardiographic and Two Dimensional Echocardiographic Visualization of the Anomalous Left Coronary Artery Arising from the Main Pulmonary Artery–A Case Report-

吳俊仁(Jiunn-Ren Wu) ； 黃德揚(The-Yang Huang) ； 尤憲明(Shang-Ming Yue) ； 鄭琇芳(Shiow-Fang Cheng)

《Acta Paediatrica Sinica》 26卷4期 (1985/08) Pp. 352-356

摘要

左冠狀動脈不正常之源發於主肺動脈是種罕見之先天性心臟血管疾病。本病例為20個月大之女嬰，因心臟衰竭及肺炎來院診治。聽診時心臟沒有心雜音，胸部X光上心臟擴大，心電圖顯示典型之心室前側壁心肌梗塞，所以懷疑此症，後經雙相超音波心圖及心臟血管攝影術均能明顯看出左冠狀動脈確實起源於主肺動脈。因國內尚沒有此種病例報告，故提出以供參考。

並列摘要

The anomalous origin of the left coronary artery arising from the main pulmonary artery without intracardiac defect is a very rare anomaly. The patient usually begins to have symptoms and signs of heart failure and frequent respiratory tract infections in the early infancy. The female patient was born smoothly in April, 1983 with birth weight of 2.5 kg. She was well until 40 days of age, when she suddenly had episodes of crying during feeding, hoarseness, dyspnea, tachypnea. cold sweating and respiratory tract infection. Cardiomyopathy was told at age 7 months following a cardiac catheterization and angiocardiography study carried out by a hospital in Taipei. Digoxin was prescribed since then. In February, 1985, she was admitted to the Kaohsiung Medical College Hospital for evaluation of her cardiac condition. There was no murmur. Liver and spleen were not enlarged. Chest X-ray showed a markedly enlarged heart. Electrocardiography disclosed anterior lateral myocardial infarction and left ventricular hypertrophy. M-mode echocardiography showed paradoxical septal motion, fish mouth appearance of the mitral valve and small amount of pericardial effusion. The left coronary artery was well visualized arising from the main pulmonary artery on two dimensional echocardiograms at high parasternal short axis view. Left ventricular cineangiography showed dilated and poor contracted globular shaped left ventricular chamber. Cineaortograms revealed only a dilated right coronary artery arising from the aorta on .the early films. The left coronary artery became visible thereafter through collateral circulations draining into the main pulmonary artery. She was advised to. receive a surgical treatment, but the family refused for fear of its possible risk. The patient was still in normal physical activities during the followup period.

並列關鍵字

aberrant left coronary artery ； anterolateral myocardial infarction ； angiocardiography ； echocardiography