congenital coronary aneurysm
Introduction
Introduction to congenital coronary aneurysms Congenital coronary aneurysm consultation is rare. Paekard reported the disease for the first time. It can occur in babies or even adults. Congenital coronary aneurysms account for only 15% of coronary aneurysms. Other causes include atherosclerosis, fungal or syphilis infection, rheumatism and mucosal subcutaneous lymph node syndrome (Kawasaki disease). Congenital coronary aneurysms are more common in the right coronary artery, usually at the bifurcation of the coronary artery, and can be single or multiple. The largest diameter of the tumor can reach 15cm. Under the microscope, it can be seen that there is a lack of elastic fibers in the middle wall of the tumor wall, and the diseased blood vessels are continuously expanding and thinning, causing pericardial tamponade and death. It is generally believed that congenital coronary aneurysms have the potential for serious complications, so once diagnosed, active surgical treatment should be performed. basic knowledge The proportion of sickness: 0.0023% Susceptible people: no special people Mode of infection: non-infectious Complications: myocardial ischemia myocardial infarction
Cause
Causes of congenital coronary aneurysm
Once a congenital coronary aneurysm ruptures, it can lead to pericardial tamponade and myocardial ischemia and infarction. If the aneurysm breaks into the pericardium, it can be suddenly filled with pericardial tamponade; if it breaks into the heart chamber or sinus, its pathophysiological changes are similar to coronary artery spasm, which can be complicated by congestive heart failure. In addition, irregularities in the inner wall of the blood vessel can lead to thrombosis in the aneurysm. In addition to thrombus detachment and embolism, myocardial ischemia is also associated with the "stealing phenomenon" of coronary aneurysms, that is, diastolic coronary blood flow into the aneurysm, and the systolic blood returns to the coronary artery. Causes a decrease in blood supply to the distal myocardium.
Prevention
Congenital coronary aneurysm prevention
Maintain an optimistic and positive attitude, develop healthy and good habits, and learn to relieve stress to a certain extent to reduce the incidence of cerebral aneurysm rupture. If the patient has sudden and severe headache, jet vomiting, disturbance of consciousness and other symptoms, the patient's respiratory tract should be kept as close as possible and promptly sent to the hospital for treatment. DSA (Digital Subtraction Angiography) is the "gold standard" for the diagnosis of cerebral aneurysms. Magnetic resonance imaging can also detect the condition of the lesion. Depending on the location of the cerebral aneurysm, interventional therapy or aneurysm neck clipping surgery can be selected. And it is found that the sooner the treatment is better.
Complication
Congenital coronary aneurysm complications Complications, myocardial ischemia, myocardial infarction
Common complications include myocardial ischemia, infarction, and aneurysm rupture due to thrombosis or embolism. Individual patients may have systolic or diastolic murmurs.
Symptom
Symptoms of congenital coronary aneurysm Common symptoms Systolic and diastolic murmurs Coronary artery stealing coronary artery embolization Coronary artery insufficiency
Children with congenital coronary aneurysms are mostly asymptomatic if they have no complications. Common complications include myocardial ischemia, infarction, and aneurysm rupture due to thrombosis or embolism. Individual patients may have systolic or diastolic murmurs. X-ray occasionally on the tumor on the tumor-like bulge and aneurysm wall calcification. Cardiac ultrasound and Doppler examination are helpful for diagnosis. Selective coronary angiography has a clear diagnosis and guidance for the treatment.
Examine
Examination of congenital coronary aneurysms
X-ray occasionally on the tumor on the tumor-like bulge and aneurysm wall calcification. Cardiac ultrasound and Doppler examination are helpful for diagnosis. Selective coronary angiography has a clear diagnosis and guidance for the treatment.
Diagnosis
Diagnosis and diagnosis of congenital coronary aneurysms
diagnosis
For the diagnosis of aortic sinus aneurysm, based on medical history, physical examination and cardiac continuity murmur, combined with X-ray film and echocardiography, it is generally not difficult to be clear. For some patients with diagnostic suspicion, a right heart catheterization or retrograde aortic angiography is required for a differential diagnosis.
Differential diagnosis
The following diseases should be differentiated from aortic sinus aneurysms:
(1) Arteriolar patent ductus arteriosus, main pulmonary artery septal defect, such as left-to-right shunt in the aorta, there is no sudden medical history, the machine-like continuous murmur is located in the left second intercostal space, and the noise is often toward the two lungs and the same side. In the subclavian region, echocardiography has left-to-right shunt in the descending aorta and left pulmonary artery. If necessary, right heart catheterization or retrograde aortic angiography can confirm the diagnosis.
(B) ventricular septal defect coexisting aortic valve regurgitation this disease has no sudden history, systolic and diastolic back and forth murmur parts in the left 2nd and 3rd intercostal space, echocardiography showed ventricular septal echo segment loss and ventricle There is a left-to-right shunt in the cavity, and the aortic valve can show signs of valve insufficiency.
(C) Coronary artery spasm: refers to the left and right coronary artery and the heart chamber or coronary veins have abnormal traffic, continuous murmur can be heard under the anterior region of the heart, mainly in the diastolic phase. Echocardiography or retrograde aortic angiography revealed an enlarged varicose of the coronary arteries, and it was seen that the contrast agent flowed from the coronary artery into the heart chamber.
