PDF(Pubmed)
Abstract：
UNASSIGNED: A coronary artery aneurysm is a rare cardiac anomaly that may be incidentally detected on echocardiography. When associated with a coronary cameral fistula, an aneurysm can become symptomatic. We present a unique case of a giant left circumflex coronary aneurysm with a fistula to the left atrium and a large atrial septal defect causing acute heart failure in a young woman during the peripartum period.
UNASSIGNED: A 32 year-old woman who presented with hypoxia after the delivery of her fourth child was found to have heart failure with severe mitral regurgitation and multiple abnormal intracardiac shunts. Echocardiography showed a large circular structure with Doppler color flow into the left atrium and between the atria. Cardiac computed tomography showed multiple dilated coronary arteries including a left circumflex coronary artery aneurysm measuring >10 cm in diameter with fistulous communication to the left atrium and a large atrial septal defect. A right heart catheterization was performed, and the patient was diagnosed with high-output heart failure. Surgical closure of the coronary cameral fistula was deferred due to the risk of worsening pressure in the coronary aneurysm, and the patient was referred for cardiac transplantation.
UNASSIGNED: This case illustrates severe heart failure as a complication of a giant coronary artery aneurysm with fistulization to the left atrium and subsequent shunting through a large atrial defect. Echocardiography allows for the detection of a coronary aneurysm and shunting, and cardiac computed tomography provides detailed visualization of a coronary cameral fistula.
UNASSIGNED: A 32 year-old woman who presented with hypoxia after the delivery of her fourth child was found to have heart failure with severe mitral regurgitation and multiple abnormal intracardiac shunts. Echocardiography showed a large circular structure with Doppler color flow into the left atrium and between the atria. Cardiac computed tomography showed multiple dilated coronary arteries including a left circumflex coronary artery aneurysm measuring >10 cm in diameter with fistulous communication to the left atrium and a large atrial septal defect. A right heart catheterization was performed, and the patient was diagnosed with high-output heart failure. Surgical closure of the coronary cameral fistula was deferred due to the risk of worsening pressure in the coronary aneurysm, and the patient was referred for cardiac transplantation.
UNASSIGNED: This case illustrates severe heart failure as a complication of a giant coronary artery aneurysm with fistulization to the left atrium and subsequent shunting through a large atrial defect. Echocardiography allows for the detection of a coronary aneurysm and shunting, and cardiac computed tomography provides detailed visualization of a coronary cameral fistula.
摘要：
■冠状动脉瘤是一种罕见的心脏异常，可以在超声心动图上偶然发现。当与冠状动脉瘘相关时，动脉瘤会有症状.我们介绍了一个独特的病例，即巨大的左回旋支冠状动脉瘤，左心房瘘和大的房间隔缺损在围产期导致一名年轻女性急性心力衰竭。
■一名32岁妇女在分娩第四个孩子后出现缺氧，被发现患有心力衰竭，伴有严重的二尖瓣反流和多个异常心内分流。超声心动图显示大的圆形结构，多普勒彩色血流进入左心房和心房之间。心脏计算机断层扫描显示多个扩张的冠状动脉，包括直径>10cm的左回旋支冠状动脉瘤，与左心房的瘘管连通和大的房间隔缺损。进行了右心导管检查,患者被诊断为高输出心力衰竭。由于冠状动脉瘤压力恶化的风险，冠状动脉瘘的手术闭合被推迟，患者接受心脏移植。
■此病例说明严重的心力衰竭是巨大的冠状动脉瘤的并发症，并伴有左心房造瘘，随后通过大的心房缺损分流。超声心动图可以检测冠状动脉瘤和分流，和心脏计算机断层扫描提供了冠状动脉冠状动脉瘘的详细可视化。
■一名32岁妇女在分娩第四个孩子后出现缺氧，被发现患有心力衰竭，伴有严重的二尖瓣反流和多个异常心内分流。超声心动图显示大的圆形结构，多普勒彩色血流进入左心房和心房之间。心脏计算机断层扫描显示多个扩张的冠状动脉，包括直径>10cm的左回旋支冠状动脉瘤，与左心房的瘘管连通和大的房间隔缺损。进行了右心导管检查,患者被诊断为高输出心力衰竭。由于冠状动脉瘤压力恶化的风险，冠状动脉瘘的手术闭合被推迟，患者接受心脏移植。
■此病例说明严重的心力衰竭是巨大的冠状动脉瘤的并发症，并伴有左心房造瘘，随后通过大的心房缺损分流。超声心动图可以检测冠状动脉瘤和分流，和心脏计算机断层扫描提供了冠状动脉冠状动脉瘘的详细可视化。
