冠状动脉肌桥与心源性猝死

冠状动脉肌桥也称冠脉肌桥或心肌桥,是一种先天性冠状动脉分布走行的发育畸形,为冠状动脉某一段或其分支的某一段走行于心外膜下的心肌层内。这种先天性冠状动脉分布走行的发育畸形可以引起猝死,在尸体解剖中也较为常见。本文对冠脉肌桥的形态学特点、临床影像学与心电图改变、猝死机制以及法医学鉴定中需要注意的问题等方面进行了阐述。

Myocardial bridging: a cause leading to sudden cardiac death

Myocardial bridging,a congenital coronary artery distribution abnormality,is defined as a segment of major epicardial coronary that goes intramurally through the myocardium beneath the muscle bridge.The inborn intramural coronary artery,so-called 'tunnelled artery',may cause sudden cardiac death although it is not infrequently detected at autopsy.The article presents the myocardial bridging in the aspects regarding its morphological characteristics,clinical angiographic and electrocardiographic findings,mechanisms leading to sudden cardiac death as well as interests in medico-legal investigation on cause of death.