Characteristics of abnormal coronary aorta origin in adults and cause analysis of missed diagnosis by transthoracic echocardiography
10.19745/j.1003-8868.2024012
- VernacularTitle:成人冠状动脉异常主动脉起源病例特点及经胸超声心动图漏诊原因分析
- Author:
Si-Yang ZUO
1
;
Sen LI
;
You-Xiang KANG
;
Xiao-Ling ZHAO
;
Li-Xing WANG
;
Rui CHEN
;
Zhi-Yu FENG
Author Information
1. 联勤保障部队第940医院超声诊断科,兰州 730050
- Keywords:
anomalous aortic origin of a coronary artery;
coronary artery;
anomalous origin of coronary artery arising from the opposite sinus;
transthoracic echocardiography
- From:
Chinese Medical Equipment Journal
2024;45(1):71-75
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the characteristics of adult anomalous aortic origin of coronary artery(AAOCA)and the causes of missed diagnosis by transthoracic echocardiography(TTE)so as to facilitate TTE in diagnosing adult AAOCA.Methods A total of 37 adult patients with AAOCA diagnosed by non-invasive coronary CT angiography(CCTA)and/or invasive coronary angiography(ICA)were selected as research samples at some hospital from January 2019 to December 2022,and their clinical symptoms and the findings of 12-lead electrocardiogram,cardiac enzymes and TTE were summarized;the patients were typed according to the site of origin of coronary artery anomalies,and the causes for the missed diagnosis of TTE were eplored.Chi-square test was used to compare the differences in TTE missed diagnoses.Results Of the 37 patients,31 ones had no or only mild symptoms;most ones had negative results in terms of 12-lead electrocardiography,cardiac enzymes,changes in the size of the cardiac chambers,segmental ventricular wall motion abnormalities and left ventricular systolic function.The patients with anomalous origin of the right coronary artery from left sinus(ARCA-L)gained the largest proportion of 59.45％(22/37);21 patients were diagnosed with anomalous origin of coronary artery arising from the opposite sinus(ACAOS)in the two examinations of TTE,of whom there were 19 cases of ARCA-L,and the detection rate of ACAOS by TTE was 87.5％;all the 13 patients origins in branches and high-grade openings were missed by TTE.The detection rate of ACAOS by TTE was significantly higher than that of coronary artery anomalies originating in branches and in high openings,and the difference was statistically significant(21/24 vs 0/13,P＜0.001).Conclusion Most adult AAOCA patients lack specificity in symptoms and related examination results.TTE has a high detection rate of ACAOS,while it is easy to miss the diagnosis of coronary artery anomalies originating from branches and high openings.Ultrasonographers have to identify false negative AAOCA by multi-section and multi-angle scanning and color Doppler flow imaging in order to reduce the rate of missed diagnosis.[Chinese Medical Equipment Journal,2024,45(1):71-75]
