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患儿,女,1胎1产,足月顺娩。体重3650g,身长51cm,出生时五项指标正常,Apgar评分1～10分钟均10分。生后第4天反应稍差,吃奶尚好,体检:呼吸平稳,心率125次,律齐、心音稍低,两肺及腹部检查未见异常,未作特殊处理。次日凌晨突然面色青灰,心跳减慢。60～20次,即行吸氧、托背、胸外心脏按摩,异丙肾上腺素等抢救措施,终因心跳停搏死亡。追问母亲孕期无特殊疾病及用药史。尸解:心肌缺血,细胞变性坏死;越状动脉开口一个在主动脉瓣附近;一个在肺动脉瓣附近。正常冠状动脉两个开口都应在主动脉瓣附近。本例冠状动脉开口一个在肺动脉,致使心肌细胞缺血坏死,造成新生儿猝死。冠
Children, women, 1 child 1 birth, full-term delivery. Weight 3650g, body length 51cm, five indicators of normal birth, Apgar score 1 to 10 minutes were 10 points. After 4 days of life, the reaction was a bit poor, and the nurse was still good. Physical examination: stable breathing, heart rate 125 times, law Qi, heart sound slightly lower, no abnormalities in both lungs and abdomen, no special treatment. Suddenly looking blue ash the next morning, slowed heartbeat. 60 to 20 times, that line oxygen, care, chest and heart massage, isoproterenol and other rescue measures, and eventually died of cardiac arrest. Asked her mother no special disease during pregnancy and medication history. Autopsy: myocardial ischemia, cell degeneration and necrosis; the opening of a villous artery near the aortic valve; one near the pulmonary valve. Normal coronary two openings should be in the vicinity of the aortic valve. In this case, an opening of the coronary artery in the pulmonary artery, resulting in myocardial ischemia and necrosis, resulting in sudden death of the newborn. crown