冠状动脉发育不良伴小心综合征1例报告并文献复习

Hypoplastic Coronary Artery Disease with Small Heart Syndrome:Report of One Case and Documents′ Review

目的:报道1例冠状动脉发育不良(HCAD)合并小心综合征。方法:患者为73岁女性,因反复心绞痛入院。有10 a高血压病史,无糖尿病史。心脏超声示主动脉瓣增厚、钙化、关闭不全,左室舒张功能减低。X线胸片示心胸比值0.40。心电图无明显异常。结果:冠脉造影示右冠脉主干从后降支以远突然变细、变短,左冠前降支及回旋支变细,左室造影正常。经钙拮抗剂及阿司匹林等药物治疗后,症状缓解出院。结论:该患者为非常少见的存活下来的HCAD,同时合并小心综合征,这可能与心肌长期缺血致心脏发育不良有关。

Objective：To report one case of hypoplastic coronary artery disease（HCAD） with small heart syndrome（SHS） and review the relative studies.Methods：An 73 years old woman admitted by angina pectoris with a history of hypertension for 10 years and without a history of diabetes.Echocardiogram showed aortic hyperplasia,calcify and incompetence.The diastole function of left ventricle decreased.X-ray suggested the heart chest ratio was 0.4.ECG was normal.Results：The results of coronary angiography showed that the trunk of right coronary artery（RCA） became thinner and shorter suddenly from the distal posterior descending coronary artery.Left anterior descending coronary artery（LAD） and left circumflex coronary artery（LCA） were thinner than normal.Left ventriculography was normal.After the treatment of calcium inhibitors and aspirin,the symptom was alleviated.Conclusion：The patient is a rare case of HCAD with SHS,which may be related to hypoplastic heart disease ascribed to long-term myocardial ischaemia.