左主干起源异常误诊为心肌炎一例

Abnormal Origin of Left Main Artery Misdiagnosed as Myocarditis in a Patient With Syncope:a Case Report

冠状动脉起源异常是胚胎发育时期冠状动脉异常发育或未能完全发育造成的,多数无血液动力学意义,临床表现取决于冠状动脉管腔是否狭窄,管腔狭窄会增加发生不良心血管事件的风险。本文报道了一例青少年女性,运动时发生晕厥,当地医院误诊为心肌炎,来我院后通过心电图、超声心动图、心脏磁共振成像、冠状动脉CT血管造影明确诊断,外科术后症状明显好转。晕厥作为左主干起源异常的首发症状虽然少见,但临床医师诊疗时需要考虑鉴别该疾病。

Abnormal origin of coronary artery is caused by abnormal or incomplete development of coronary artery during embryonic development.Most abnormal origin of coronary artery has no hemodynamic significance,and the clinical manifestations depend on whether there is coronary artery lumen narrowing,narrowed coronary artery lumen will increase the risk of adverse cardiovascular events.This report describes a case of adolescent female who suffered from syncope during exercise and was misdiagnosed as myocarditis by the local hospital.After admission to our hospital,the diagnosis of abnormal origin of left main artery was confirmed by electrocardiogram,echocardiography,cardiac MRI and coronary artery CT angiography,and the symptoms improved significantly after surgery.Although syncope as the first clinical symptom of abnormal origin of left main artery is rare,clinicians need to be aware of this disease in the diagnosis process of syncope.