全球精选文摘 - 超声心动图诊断无症状先天性冠状动脉异常

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超声心动图诊断无症状先天性冠状动脉异常

Echocardiographic diagnosis of clinically silent congenital coronary artery anomalies

Lytrivi ID, Wong AH, Ko HH 2009/5/27 10:48:50

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Int J Cardiol, 2008,

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Abstract
Background:
The incidence of congenital coronary anomalies is mainly derived from autopsy series and pre-participation exams in athletes. Limited data exist regarding the spectrum of coronary anomalies that can be detected in asymptomatic patients. We sought to describe echocardiographically detected congenital coronary artery anomalies in asymptomatic children after implementing a screening protocol mandating identification of coronary artery origin and proximal course in all initial studies.

Methods:
Our database was searched from 1/1/1993 to 3/31/2006 and all echocardiograms coded for coronary anomalies were identified. Clinically “silent” congenital coronary anomalies were culled from that group.

Results:
Of the 168 “silent” coronary anomalies detected, 111 were anomalies of aortic origin, including 59 patients with “high coronary takeoff” and 30 patients with “wrong sinus” origin of either the left or right coronary artery. Small coronary fistulas were seen in 57. Associated congenital heart defects were found in 53% of individuals with coronary anomalies.

Conclusions:
This study comprises the largest group of echocardiographically detected, “silent” but potentially clinically significant, congenital coronary anomalies in children. Prospective echocardiographic diagnosis of “high coronary takeoff”, a risk factor for injury during cardio-pulmonary bypass, and asymptomatic intraseptal coronary stenosis are described for the first time.

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疾病资源中心

高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

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