中年女性に認められた孤立性左冠動脈入口部狭窄の1例

A Case of Middle Aged Woman with Isolated Left Coronary Ostial Stenosis

　患者は50歳女性．狭心症の精査で当科に入院．冠危険因子は認めず，炎症反応，血清梅毒反応は陰性であった．運動負荷心電図でⅡ，Ⅲ，aⅤ_F，Ⅴ_3-6でST低下を認めた．冠動脈造影時カテーテルの挿入に伴い，先端圧の著明な低下を認めた．造影上左冠動脈入口部に75％狭窄を認めたが，他の部位には全く狭窄像が認められず，いわゆる原因不明の孤立性冠動脈入口部狭窄と考えられた．本症は狭義の動脈硬化による虚血性心疾患とは明確に区別されるべき疾患概念と考えられ，その成因について今後症例を重ねた検討が必要である．

A-50-year-old woman was admitted to our hospital for the examination of exertional chest pain. She had no coronary risk factors. No hormonal disorders were observed. Physical and laboratory examinations revealed that she had not suffered from syphilis or aortitis syndrome or any other inflammatory diseases. An exercise electrocardiogram (Master's test) demon-strated ST segment depression in Ⅴ_3-6, Ⅱ, Ⅲ and aⅤ_F. On coronary angiography, a 75% stenosis of the left coronary ostial stenosis was found, but no abnomality was found in other arterial trees. The patient was diagnosed as having isolated coronary ostial stenosis.