Multivessel coronary artery vasospasm masquerading as surgical coronary atherosclerotic disease

2021 ◽  
Author(s):  
Navneet Singh ◽  
Parma Nand
Keyword(s):  
Coronary Artery ◽  
Atherosclerotic Disease ◽  
Coronary Artery Vasospasm

scholarly journals A case report of a symptomatic right anomalous coronary artery with concomitant atherosclerotic disease: the benefit of a sequential comprehensive non-invasive and invasive diagnostic approach

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Marius Reto Bigler ◽  
Adrian Thomas Huber ◽  
Lorenz Räber ◽  
Christoph Gräni
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Myocardial Ischaemia ◽  
Invasive Coronary Angiography ◽  
Atherosclerotic Disease ◽  
Diagnostic Approach ◽  
Anomalous Coronary Artery ◽  
Atherosclerotic Stenosis ◽  
Anomalous Coronary

Abstract Background  Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital disease associated with an increased risk of myocardial ischaemia, ventricular arrhythmias, and heart failure. Case summary  A 75-year-old Caucasian man was referred for invasive coronary angiography (ICA) due to atypical chest pain. Invasive coronary angiography demonstrated non-significant atherosclerotic disease of the left coronary artery and an anomalous origin of the right coronary artery (RCA); without selective intubation. Coronary computed tomography angiography (CCTA) revealed a right-AAOCA with interarterial and intramural course, and a soft plaque in the distal RCA. Subsequent physical-stress single-photon emissions computed tomography (SPECT) showed exercise-induced inferoapical myocardial ischaemia, giving a Class IC level of evidence for surgical correction of the AAOCA. Repeated ICA with selective R-AAOCA intubation confirmed an 80% distal atherosclerotic stenosis, which was treated with direct stenting. Subsequent invasive physiologic evaluation under maximal dobutamine-volume challenge (gradually increasing dose of dobutamine max. 40 μg/kg per body weight/min, 3000 mL ringer lactate and 1 mg atropine was given until the patient reached a maximum of 145 b.p.m.), revealed a haemodynamically non-relevant anomalous segment with a fractional flow reserve (FFR) of 0.91. A follow-up SPECT was normal, and the patient was completely symptom-free at 1 month. Discussion  We present the sequential diagnostic approach in a symptomatic patient with a right anomalous coronary artery and concomitant atherosclerotic disease. Using this approach, the patient could be deferred from guideline recommended open-heart surgery of the AAOCA, as direct invasive dobutamine/volume FFR revealed haemodynamic non-relevance of the anomalous segment after stenting the concomitant atherosclerotic stenosis in the distal segment within the same coronary artery.

scholarly journals Diffuse coronary artery vasospasm in a patient with subarachnoid hemorrhage: A case report

2020 ◽  
Vol 12 (9) ◽  
pp. 468-474
Author(s):  
Dennis Grewal ◽  
Adeba Mohammad ◽  
Pooja Swamy ◽  
Islam Abudayyeh ◽  
Mamas A Mamas ◽  
...  
Keyword(s):  
Case Report ◽  
Subarachnoid Hemorrhage ◽  
Coronary Artery ◽  
Coronary Artery Vasospasm

scholarly journals Control of blood pressure levels in patients with premature coronary artery disease: Results from the Genetics of Atherosclerotic Disease study

2020 ◽  
Vol 22 (7) ◽  
pp. 1253-1262 ◽  
Author(s):  
Esteban Jorge‐Galarza ◽  
Froylan D. Martínez‐Sánchez ◽  
Cesar I. Javier‐Montiel ◽  
Aida X. Medina‐Urrutia ◽  
Carlos Posadas‐Romero ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Atherosclerotic Disease ◽  
Premature Coronary Artery Disease ◽  
Artery Disease ◽  
Disease Study

scholarly journals DIFFUSE CORONARY ARTERY VASOSPASM: A STEMI MASQUERADE IN A PATIENT WITH SUBARACHNOID HEMORRHAGE

2020 ◽  
Vol 75 (11) ◽  
pp. 3031
Author(s):  
Dennis Grewal ◽  
Adeba Mohammad ◽  
Pooja Swamy ◽  
Islam Abudayyeh ◽  
Purvi Parwani
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Coronary Artery ◽  
Coronary Artery Vasospasm

Coronary Artery Calcification and Coronary Atherosclerotic Disease

2012 ◽  
Vol 30 (1) ◽  
pp. 19-47 ◽  
Author(s):  
Ramil Goel ◽  
Pankaj Garg ◽  
Stephan Achenbach ◽  
Abha Gupta ◽  
Jeremy J. Song ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Atherosclerotic Disease
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