左冠状动脉—肺动脉瘘

2018-08-02 付世文 鸢都超声

冠状动脉瘘是指冠状动脉的血液从冠状动脉瘘分流到有关心腔和血管,为冠状动脉异常中发病率较高的一种疾病,多发生于右冠状动脉,约占90%,远高于左冠状动脉瘘。

概述

冠状动脉瘘是指冠状动脉的血液从冠状动脉瘘分流到有关心腔和血管,为冠状动脉异常中发病率较高的一种疾病,多发生于右冠状动脉,约占90%,远高于左冠状动脉瘘。

病例分享

病人女性,27岁,近来偶有心前区不适、心慌就诊。自述小时候不能长时间和剧烈运动。


左房、左室轻度增大


左冠状动脉增宽,内径:6.5mm,右冠状动脉内径:4.0mm。






冠状动脉前降支与肺动脉之间见丰富血流信号,呈点状分布。肺动脉内探及以舒张期为主的分流信号。

鉴别诊断

冠状动脉瘘易与冠状动脉异常位起源于肺动脉相混淆。冠状动脉瘘通常为患侧的冠状动脉内径增宽,而且增宽的程度较冠状动脉起源异常更明显。因为左、右冠状动脉在心肌内存在侧支循环,如果冠状动脉起源于肺动脉时,因主动脉压力明显高于肺动脉,所以异位起源的冠状动脉血流方向为:冠状动脉→肺动脉,出现肺动脉窃血现象。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=335932, encodeId=f823335932de, content=有意思的病理改变!, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7e71713450, createdName=太阳系小猪, createdTime=Fri Aug 03 07:05:42 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335834, encodeId=d2bb33583451, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/2EVCwc9WmQS6ec99H2TX8ejmR40xYjwrIcrqjAnibV36aicL1sLxc21rhpZnqTOxk33HP44iayEwo6qYXqgZvdRtA/132, createdBy=d0d01573846, createdName=329523732, createdTime=Thu Aug 02 20:39:24 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335832, encodeId=3e97335832ef, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Thu Aug 02 20:20:07 CST 2018, time=2018-08-02, status=1, ipAttribution=)]
    2018-08-03 太阳系小猪

    有意思的病理改变!

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=335932, encodeId=f823335932de, content=有意思的病理改变!, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7e71713450, createdName=太阳系小猪, createdTime=Fri Aug 03 07:05:42 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335834, encodeId=d2bb33583451, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/2EVCwc9WmQS6ec99H2TX8ejmR40xYjwrIcrqjAnibV36aicL1sLxc21rhpZnqTOxk33HP44iayEwo6qYXqgZvdRtA/132, createdBy=d0d01573846, createdName=329523732, createdTime=Thu Aug 02 20:39:24 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335832, encodeId=3e97335832ef, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Thu Aug 02 20:20:07 CST 2018, time=2018-08-02, status=1, ipAttribution=)]
    2018-08-02 329523732

    不错

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=335932, encodeId=f823335932de, content=有意思的病理改变!, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7e71713450, createdName=太阳系小猪, createdTime=Fri Aug 03 07:05:42 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335834, encodeId=d2bb33583451, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/2EVCwc9WmQS6ec99H2TX8ejmR40xYjwrIcrqjAnibV36aicL1sLxc21rhpZnqTOxk33HP44iayEwo6qYXqgZvdRtA/132, createdBy=d0d01573846, createdName=329523732, createdTime=Thu Aug 02 20:39:24 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335832, encodeId=3e97335832ef, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Thu Aug 02 20:20:07 CST 2018, time=2018-08-02, status=1, ipAttribution=)]
    2018-08-02 惠映实验室

    学习了,谢谢分享。

    0