左主干冠状动脉瘤误诊一例

摘要

目的 探讨冠状动脉瘤的病因、诊断及治疗,以降低误诊率.方法 对我科收治的1例左主干冠状动脉瘤的临床资料进行回顾性分析.结果 本例为59岁女性,发作性胸闷、胸痛10年,近日发作频繁,于外院行运动负荷试验拟诊为冠心病.入我科后行冠状动脉造影检查,明确诊断为左主干冠状动脉瘤,予药物治疗好转后出院.结论 冠状动脉瘤的主要临床表现是心绞痛,临床上易误诊为冠心病.冠状动脉造影是确诊本病的主要方法,目前可采用药物治疗、介入治疗和外科手术治疗.%Objective To explore the etiology,diagnosis and treatment of the coronary aneurysm (CA),and to reduce the misdiagnosis rate.Methods Clinical data of a patient with left and main CA in our department were retrospectively analyzed.Results A 59-year-old woman was admitted for paroxysmal chest distress and chest pain for ten years.The patient was diagnosed as having coronary heart disease by treadmill exercise test in other hospitals.In our department the patient was confirmed as having left and main CA by coronary arteriongraphy,and was treated with pharmacotherapy.The patient's pathogenetic condition improved and was discharged.Conclusion The primary symptom of coronary aneurysm is angina pectoris,and CA is easily misdiagnosed as coronary heart disease.Coronary arteriongraphy is the main approach of final diagnosis,and CA treatment includes pharmacotherapy,interventional operation and surgical treatment at present.