漏出性自然冠動脈偽動脈瘤

A leaking spontaneous coronary artery pseudoaneurysm.

• Qiangjun Cai
• Syed Gilani

抄録

78 歳男性が胸痛と ST 分節上昇を呈した．冠動脈造影では有意な冠動脈疾患は認められなかった．冠動脈に偽動脈瘤と思われる造影剤のポケットが右末梢後下行冠動脈の外側に認められた．心エコーでは左心房後方に心嚢液ポケットを認め，血行性心膜症を疑った．疑似動脈瘤の治療は緊急に行われ、2つのコイルを配備して疑似動脈嚢の完全な排除と後下行冠動脈遠位部の閉塞を得ることに成功した。

A 78-year-old man presented with chest pain and ST segment elevation. Coronary angiography showed no significant coronary artery disease. A saccular pocket of contrast material was found outside of the distal right posterior descending coronary artery consistent with a pseudoaneurysm. Echocardiography showed a pocket of pericardial fluid behind the left atrium concerning for a hemopericardium. The pseudoaneurysm was treated urgently with two coils successfully deployed to obtain complete exclusion of the pseudoaneurysm sac and occlusion of the distal portion of the posterior descending coronary artery.

Copyright © 2020 Baylor University Medical Center.