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首页> 外文期刊>European Heart Journal - Case Reports >An incidental finding of a bicuspid aortic valve and pseudocoarctation of the descending aorta in a patient presenting with an acute coronary syndrome: a case report
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An incidental finding of a bicuspid aortic valve and pseudocoarctation of the descending aorta in a patient presenting with an acute coronary syndrome: a case report

机译：涉及患有急性冠状动脉综合征的患者中下降主动脉的双裂主动脉瓣膜和假性切口的偶然发现：案例报告

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Background Aortic pseudocoarctation (PsCoA) is an elongation of the supra-isthmic aorta with kinking and low-grade narrowing. Consequently, no collateral circulation is found. It is frequently associated with other congenital heart anomalies, such as bicuspid aortic valve (BAV). Case summary We report the case of 60-year-old patient who presented to the ED with acute chest pain. Physical examination was remarkable for an elevated blood pressure (BP) and the presence of a systolic murmur on the left lower sternal border. An acute coronary syndrome was suspected and the patient underwent urgent coronary angiogram which showed an occluded obtuse marginal artery. Additionally, the presence of an aortic anomaly was noted during the aortography, and additional work-up, including a thoracic computed tomography angiography and transoesophageal echocardiography, revealed a BAV and a PsCoA of the descending aorta. The patient was discharged after optimizing BP control with oral medication and periodical follow-up was arranged. Discussion Aortic PsCoA may mimic true coarctation (CoA), but the absence of a haemodynamically significant descending aortic narrowing and of the typical clinical findings associated with aortic CoA, distinguishes both entities. Treatment is therefore conservative and based on the control of cardiovascular risk factors and in particular of arterial hypertension. Work-up should include imaging of the entire aorta and the search for associated congenital cardiac anomalies, which, if present, should be managed in consequence.
机译：背景技术主动脉伪变性（PSCOA）是具有扭结和低级缩小的Supra-Isthmic主动脉的伸长。因此，没有发现附带循环。它通常与其他先天性心脏异常相关，例如双囊主动脉瓣（BAV）。案例摘要我们举报了60岁的患者，患有急性胸痛的患者。血压升高（BP）和左下胸骨边界上存在收缩杂音的体检是显着的。怀疑急性冠状动脉综合征，患者接受迫切冠状动脉血管造影，显示出闭塞钝边动脉。另外，在主动脉造影期间注意到主动脉异常的存在，以及额外的后续处理，包括胸部计算的断层造影血管造影和转燕超声心动图，显示了下降主动脉的BAV和PSCOA。在使用口服用药优化BP对照之后，患者进行排出，并安排了期刊随后。讨论主动脉性PSCOA可能模拟真正的克切（COA），但没有血管动力学上下降的主动脉缩小和与主动脉COA相关的典型临床发现，区分了两个实体。因此，治疗是保守的，并基于对心血管危险因素和动脉高血压的控制。工作应包括整个主动脉的成像，并寻求相关的先天性心脏异常，如果存在，应当得到管理。

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