心脏多层计算机断层扫描对高血压患者胸痛的评价

Marwa Hesham Ellaboudy, Mohamed Ahmed Youssef, Rasha Mahmoud Dawoud, Ekhlas Abdelmonem Shaban
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摘要

背景:高血压(HTN)是冠心病(CHDs)和脑卒中的主要危险因素。冠状动脉计算机断层扫描(CT)使医生能够以高特异性和敏感性可视化冠状动脉血管系统。研究目的:评价CT冠状动脉造影在HTN患者胸痛诊断中的作用。患者和方法:本前瞻性研究对30例以急性胸痛为表现的HTN患者进行了研究。患者进行冠状动脉多层螺旋CT血管造影时,心率应自发或β -受体阻滞剂诱导< 70次/分钟/次。结果:17例患者表现为典型胸痛(56.7%)。其余为非典型胸痛(43.3%)。冠状动脉病变分布:以左冠状动脉前降支为主,其次为右冠状动脉。左侧冠状动脉前降支病变占60%,右侧冠状动脉病变占35%。20%的患者有左主干冠状动脉病变。15%的患者左旋冠状动脉受影响。支、D1、D2受影响最小。非冠状动脉病变为:主动脉瘤1例,肺栓塞1例,主动脉夹层1例。结论:ct血管造影(CTA)是一种快速、可靠、无创的高血压急性胸痛诊断辅助手段。
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Cardiac multi-slice computed tomography in evaluation of chest pain in hypertensive patients
Background: Hypertension (HTN) is a major risk factor for coronary heart diseases (CHDs) and stroke. Coronary computed tomography (CT) enables physicians to visualize the coronary vascular system with high specificity and sensitivity. Aim of the work: To evaluate the role of CT coronary angiography as a diagnostic tool in the assessment of chest pain in patients suffering from HTN. Patients and Methods: This prospective study was carried out on 30 patients with HTN presented with acute chest pain. Heart rate should be < 70 beat/min bpm spontaneously or beta-blocker induced then the patients subjected to multi slice CT angiography of coronary arteries. Results: 17 patients presented with typical chest pain (56.7%). The rest of were suffering from atypical chest pain (43.3%). The distribution of coronary lesions was: the most affected artery is the left anterior descending coronary artery followed by the right coronary artery. Sixty percent of patients had left anterior descending coronary lesion while 35 % had right coronary lesion. The left main coronary was affected in 20 % of patients. The left circumflex coronary was affected in 15 % of these patients. The ramus, D1, and D2 were the least affected. The non-coronary lesions were: aortic aneurysm (1 patient), pulmonary embolism (1 patient), and aortic dissection (1 patient).Conclusions: Computed tomography angiography (CTA) is a good fast reliable non-invasive diagnostic aid for hypertensive patients with acute chest pain.
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