[Right coronary ostial stenosis in homozygotic hypercholesterolemia. Coronarographic and echocardiographic diagnosis].
Ostial stenosis of the right coronary artery was discovered in 2 patients with homozygous familial hypercholesterolaemia. The lesion was confirmed in one case at post-mortem examination and in the other case by cross-sectional echocardiography. In both patients the stenosis could not be visualized at coronary arteriography when the right coronary vessel was selectively injected, but the lack of reflux of the contrast medium into the aortic sinus proved very useful for the diagnosis. To recognize this sign is important since the other criteria of ostial stenosis are not always present, notably in essential hypercholesterolaemia where post-stenosis dilatation is absent due to diffuse parietal lesions of the arteries. In addition, ostial stenoses are associated with a characteristic stenosis localized to the proximal aorta above the coronary ostia. Owing to the dangers of overlooking ostial stenoses, echocardiography and aortography should be performed before coronary arteriography, and the lack of reflux of the contrast medium should be acknowledged as a diagnostic sign.
D000293:Adolescent; D000328:Adult; D003251:Constriction, Pathologic; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D004452:Echocardiography; D005260:Female; D006720:Homozygote; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000150:complications*; D008297:Male
Sténoses ostiales coronaires droites dans l'hypercholestérolémie homozygote. Diagnostic coronarographique et échocardiographique.