PDF(Pubmed)
Abstract：
The isolated origin of the left coronary artery (LCA) ostium at the level of the sinotubular junction (STJ) has been described previously. Congenital absence of the left circumflex (LCx) coronary artery has also been documented with superdominant right coronary arterial circulation, either in the presence or absence of coronary artery obstruction. Earlier literature has linked the association of an absent LCx coronary artery with a superdominant right coronary artery (SRCA) but not with a hypoplastic LCx coronary artery (HLCx). The present case report details the case of a 37-year-old thin, athletic male with the risk factors of diabetes and hypertension who was admitted to the emergency unit of our hospital for losing consciousness while bicycling in the street. The current report establishes a combined association of LCA anomaly origin at STJ level along with HLCx and SRCA condition with the burden of mild to moderate coronary artery disease involving proximal left anterior descending artery, LCx, and mid right coronary artery in the literature for the first time. Further, the case report advocated that the presented case carries the risk of malignancy. Hence, with the advancement of modern imaging technologies, computed tomography angiography should be the first choice of imaging modality rather than coronary angiography to prevent fatal outcomes. Interventional cardiologists, cardiothoracic surgeons, and radiologists should have properly defined knowledge of coronary artery anatomy and associated pathology, as it is important for coronary cannulation or any coronary interventions.
摘要：
先前已经描述了窦管交界处（STJ）水平的左冠状动脉（LCA）口的孤立起源。左旋支（LCx）冠状动脉的先天性缺失也被证明与右冠状动脉的优势循环有关。无论是否存在冠状动脉阻塞。较早的文献将LCx冠状动脉缺失与优势右冠状动脉（SRCA）联系起来，而与发育不良的LCx冠状动脉（HLCx）无关。本病例报告详述了一名37岁瘦弱的病例，患有糖尿病和高血压危险因素的运动男性，因在街上骑自行车时失去意识而被送往我们医院的急诊室。当前的报告建立了STJ水平的LCA异常起源以及HLCx和SRCA状况与涉及左前降支近端的轻中度冠状动脉疾病的负担的组合关联。LCx,文献中首次出现右冠状动脉中段。Further,该病例报告主张，该病例具有恶性肿瘤的风险。因此，随着现代成像技术的进步，计算机断层扫描血管造影应该是成像模式的首选,而不是冠状动脉血管造影,以防止致命的结局.介入心脏病学家,心胸外科医生,和放射科医生应该有正确定义的冠状动脉解剖和相关病理学知识，因为这对于冠状动脉插管或任何冠状动脉介入治疗很重要。
