冠動脈造影法と心筋コントラストエコー法の併用が診断に有用であった単冠動脈の1例

Abstract

A 73-year-old male diagnosed with angina pectoris at a nearby clinic in July 1987 at the age of 67, consulted our clinic complaining of frequent episodes of precordial pain during effort in the past one month in August 1993. Coronary angiography was performed on September 8, and revealed the presence of a 90% stenosis in the left main trunk and total obstruction of segment 7 in the left anterior descending artery supplying collateral flows from the left circumflex artery, the absence of a right coronary artery, and the left circumflex artery running through the inferior wall. Myocardial contrast echocar- diography(MCE)revealed full-circumferential elevation of the echo intensity after loading contrast dye. On the basis of these findings, the patient was diagnosed as having only a left coronary artery(Smith type Ⅰ). In the past, the diagnosis of single coronary artery was based on angiographic observation. However, diagnosis based on angiography alone sometimes involves technical difficulties. MCE can be performed during angiography and allows identification of the area supplied by the coronary artery. In the presest case, the area supplied by the single coronary artery could be identified by MCE performed during coronary angiography. The combination of MCE and angiography seems to be useful for diagnosis of single coronary artery.