Kranskärlsanomali vanlig orsak till plötslig hjärtdöd hos unga. Ovanlig diagnos som kräver riktad utredning för att inte missas
Engelsk titel: Coronary artery anomaly common cause of sudden cardiac death in young people. Unusual diagnosis that requires a targeted investigation in order not to be missed
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Författare:
Fischer, Hanna
;
Hedman, Anders
;
Öhman, Tomas
Email: hanna.fischer@sodersjukhuset.se
Språk: Swe
Antal referenser: 12
Dokumenttyp:
Fallbeskrivning
UI-nummer: 15087578
Sammanfattning
17-year old male was admitted after syncope during exercise, exhibiting transient ST-elevation, raised troponin T levels and regionally hypokinetic myocardium. Further
investigation revealed a left main coronary artery arising from the right sinus valsalva, a narrow vessel with an intramural course resulting in compression during systole. The
patient had presented previously with chest pain and syncope during physical exercise. After CT-angiography, ECG, Tilt-test and ECHO he was diagnosed with vasomotor
induced syncope. Anomalous coronary arteries have been found to be one of the three most common causes of sudden cardiac death in young individuals. Symptomatic
individuals present with chest pain and/or syncope on exertion. Diagnosis can be made by coronary angiography or CT angiography. Standard investigation of syncope is
likely to miss the diagnosis. The management of left main coronary arising from the right sinus valsalva is generally surgical.