Cardiac Computed Tomography of Congenital Absent Left Circumflex Coronary Artery: A Case Report

先天性缺乏左迴旋枝冠狀動脈之心臟電腦斷層影像：病例報告

曾芸軒(Yun-Hsuan Tzeng) ； 藍功堯(Gong-Yau Lan) ； 殷偉賢(Wei-Hsian Yin) ； 黃忠清(Chung-Ching Huang) ； 吳雨津(Yu-Chin Wu)

《中華放射線醫學雜誌》 34卷4期 (2009/12) Pp. 273-276

摘要

先天性缺乏左迴旋枝冠狀動脈是一個非常罕見的異常。文獻中只有少數以傳統血管攝影診斷出之病例。我們報告一個有類似心絞痛症狀的先天性缺乏左迴旋枝冠狀動脈病例，其接受了心臟電腦斷層掃描。一位七十一歲的男性病患因為運動時有間歇性的胸悶症狀，被轉介來做心臟電腦斷層檢查。他之前所做的鉈－201心肌灌注檢查有異常發現，而運動心電圖檢查則沒有明確結論。心臟電腦斷層血管攝影並沒有發現他有冠狀動脈粥狀硬化疾病，但是發現他缺乏左迴旋枝冠狀動脈。對於這種罕見異常的臨床症狀及心臟電腦斷層表現有所認識，是精確診斷和適當治療的關鍵。

並列摘要

Congenital absent left circumflex coronary artery (LCX) is a very rare anomaly. Only a few cases diagnosed by conventional angiography were reported in the literature. We report a case of congenital absent LCX with angina-like symptoms diagnosed by cardiac computed tomography (CT) scan. A 71-year-old male patient with intermittent chest tightness during exercise was referred to our department for cardiac computed tomography (CT) study. The thallium-201 myocardial perfusion study showed positive finding and the result of treadmill exercise electrocardiogram was inconclusive. No evidence of atherosclerotic coronary artery disease but total absence of LCX was found in the CT study. Knowledge of the clinical manifestations and cardiac CT appearances of this rare anomaly are essential for accurate diagnosis and proper treatment.