scholarly journals A Rare Coincidence of Two Coronary Anomalies in an Adult

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Cesar Cruz ◽  
Dalton Mclean ◽  
Matthew Janik ◽  
Paolo Raggi ◽  
A. Maziar Zafari
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Chest Pain ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Coronary Anomalies ◽  
Left Main ◽  
Atypical Chest Pain ◽  
Selective Coronary Angiography ◽  
Type Iv

Anomalous right-sided left main coronary arteries and dual type IV left anterior descending arteries are rare coronary anomalies. In this case report, we present a 59 year old man with atypical chest pain and a combination of the above coronary anomalies as identified by selective coronary angiography and computed tomography angiography. To the best of our knowledge, the coincidence of these coronary anomalies has not been previously described.

scholarly journals Aberrant left main coronary artery induced asymptomatic heart failure

2016 ◽  
Vol 3 (4) ◽  
pp. 69
Author(s):  
Bankim Patel ◽  
Aravindan Jeyarajasingam ◽  
Kunal Patel ◽  
Rupen Patel ◽  
Daniel Benatar
Keyword(s):  
Differential Diagnosis ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Left Main Coronary Artery ◽  
Shortness Of Breath ◽  
Coronary Anomalies ◽  
Left Main ◽  
The Right

We report a case of a malignant course of left main coronary artery in a patient presenting with sudden onset chest pain and shortness of breath. The patient is a 44-year-old African American male with a past medical history of hypertension, diabetes mellitus type 2 as well as dyslipidemia presented to the emergency department with non-exertional chest pain radiating to the left arm and shortness of breath. A coronary angiography and CT angiography (CTA) of heart was performed and it demonstrated an aberrant malignant course of the left main coronary artery coming from the right coronary ostium and coursing between the aorta and pulmonary artery. The left ventricular dysfunction was thought to be a consequence of this malignant course. Cardiothoracic surgery was consulted which determined the need for CABG. The incidence of coronary anomalies and patterns in a series of 1,950 angiograms was determined to be 5.64% with the left main coronary artery (LMCA) arising from the right sinus in 0.15% of the angiograms Diagnostic approach for malignant coronary arteries involves coronary angiography and cardiac CT. A widely accepted treatment approach for left main coronary arteries originating from the right sinus is through surgical repair. Our case urges the clinician to expand the differential diagnosis in young to middle age patient presenting with chest pain. In addition, our case reinforces the concept of the detrimental impact of malignant left coronary arteries on cardiac function. This should prompt the physician to consider coronary anomalies as a possible differential diagnosis as part of the evaluation and management of these patients.

scholarly journals Sex associations and computed tomography coronary angiography-guided management in patients with stable chest pain

2019 ◽  
Vol 41 (13) ◽  
pp. 1337-1345 ◽  
Author(s):  
Kenneth Mangion ◽  
Philip D Adamson ◽  
Michelle C Williams ◽  
Amanda Hunter ◽  
Tania Pawade ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chest Pain ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Standard Care ◽  
Absolute Risk ◽  
Risk Difference ◽  
Computed Tomography Coronary Angiography ◽  
Open Label ◽  
Normal Coronary Arteries

Abstract Aims The relative benefits of computed tomography coronary angiography (CTCA)-guided management in women and men with suspected angina due to coronary heart disease (CHD) are uncertain. Methods and results In this post hoc analysis of an open-label parallel-group multicentre trial, we recruited 4146 patients referred for assessment of suspected angina from 12 cardiology clinics across the UK. We randomly assigned (1:1) participants to standard care alone or standard care plus CTCA. Fewer women had typical chest pain symptoms (n = 582, 32.0%) when compared with men (n = 880, 37.9%; P < 0.001). Amongst the CTCA-guided group, more women had normal coronary arteries [386 (49.6%) vs. 263 (26.2%)] and less obstructive CHD [105 (11.5%) vs. 347 (29.8%)]. A CTCA-guided strategy resulted in more women than men being reclassified as not having CHD {19.2% vs. 13.1%; absolute risk difference, 5.7 [95% confidence interval (CI): 2.7–8.7, P < 0.001]} or having angina due to CHD [15.0% vs. 9.0%; absolute risk difference, 5.6 (2.3–8.9, P = 0.001)]. After a median of 4.8 years follow-up, CTCA-guided management was associated with similar reductions in the risk of CHD death or non-fatal myocardial infarction in women [hazard ratio (HR) 0.50, 95% CI 0.24–1.04], and men (HR 0.63, 95% CI 0.42–0.95; Pinteraction = 0.572). Conclusion Following the addition of CTCA, women were more likely to be found to have normal coronary arteries than men. This led to more women being reclassified as not having CHD, resulting in more downstream tests and treatments being cancelled. There were similar prognostic benefits of CTCA for women and men.

scholarly journals Congenital Absence of Left Circumflex Artery Detected by Computed Tomography Coronary Angiography: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Keerati Hongsakul ◽  
Ruedeekorn Suwannanon
Keyword(s):  
Computed Tomography ◽  
Congenital Anomaly ◽  
Coronary Angiography ◽  
Computed Tomography Coronary Angiography ◽  
Congenital Absence ◽  
Coronary Anomalies ◽  
Circumflex Artery ◽  
Atypical Chest Pain ◽  
Rare Congenital Anomaly ◽  
Left Circumflex Artery

The congenital absence of the left circumflex artery (LCx) is a very rare congenital anomaly of coronary arteries, but it is benign. Currently, the best modality for the diagnosis of coronary anomalies is computed tomography coronary angiography (CTCA). We report a case of congenitally absent LCx with an atypical chest pain.

THU0592 INSIDIOUS CORONARY ARTERY DISEASE IN A YOUNG PATIENT WITH POLYARTERITIS NODOSA: A CASE REPORT AND REVIEW OF LITERATURE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 538-539
Author(s):  
H. Huang ◽  
Z. Zhang
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Polyarteritis Nodosa ◽  
Computed Tomography Angiography ◽  
Coronary Stenosis ◽  
Coronary Computed Tomography Angiography

Background:Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that typically affects medium-sized muscular arteries, with occasional involvement of small muscular arteries[1]. Although overt myocardial infarction is uncommon, myocardial ischemia may result from narrowing or occlusion of the coronary arteries[2].Objectives:Herein, we report a case with 7-year’s history of PAN and unstable angina pectoris due to coronary occlusions of the three main arteries. We also reviewed the literatures regarding coronary artery involvement in PAN.Methods:A 22-year-old Chinese man who presented with chest pain lasting for a few minutes and then subsiding spontaneously for 1 month was admitted to our hospital. He was diagnosed as PAN 7 years ago and during 7-years’ follow-up, he has been in stable condition, without any discomfort or abnormal laboratory findings. In December 2019, he suffered from chest distress accompanied by retrosternal pain, with frequency of about 2-3 times a week. His symptoms were gradually aggravating with dyspnea at night.Results:Coronary computed tomography angiography showed diffuse coronary stenosis (Fig. 1). Further coronary angiography revealed a slight plaque infiltration of the left main coronary artery, and occlusion of all the three major coronary arteries, as well as multiple coronary aneurysms. 95% stenosis of the obtuse margin branch artery was also found and a stent was then implanted (Fig. 2). Prednisone 50mg/day and methotrexate 15mg/week were reinitiated, in combination with anti-anginal medications including aspirin and statin.Fig. 1Coronary computed tomography angiography found diffuse coronary stenosis.Fig. 2Coronary angiography. (a) A 50% stenosis followed by aneurysmal change of the proximal end of left anterior descending (LAD) artery, and totally occluded from the middle segment; A aneurysmal change of the initial part of left circumflex artery (LCX) and then totally occluded (dotted line); A 95% stenosis obtuse margin branch. (b) A totally occluded right coronary artery (dotted line). (c) Final appearance of the LCX after stent implantation.After we reviewed all the English literatures reporting cardiac involvements in adults with PAN from 1990 to 2019, a total of 34 patients from 32 articles were identified. 25 (73.5%) patients were admitted to hospital due to acute coronary syndromes manifesting as chest pain or dyspnea. Coronary stenosis or occlusions were most common on imaging or autopsy. Most of the patients had more than one vessel involved, of whom 7 patients showed evidence of triple vessel lesions. Aneurysm was also common in these patients, especially multiple aneurysms. Spontaneous coronary artery dissections were rare in PAN patients. Most patients received glucocorticoid, and/or immunosuppressant therapy, including cyclophosphamide and azathioprine, with or without invasive operations. 15 patients died from cardiopulmonary arrest, the most frequent cause being death, and 15 patients were stable without symptoms after treatment.Conclusion:We report a young PAN patient with insidious stenosis of three main coronary arteries under the circumstance of stable disease activity for years. This reminds us of the necessity of assessing heart, probably other organs as well, in PAN patients even though their acute phase reactants in serum are normal. But how often to do the screening and which screening examination should be done, remain to be further investigated.References:[1]Jennette, J.C., et al.,2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides.Arthritis Rheum, 2013.65(1): p. 1-11.[2]Kastner, D., M. Gaffney, and T. Tak,Polyarteritis nodosa and myocardial infarction.Can J Cardiol, 2000.16(4): p. 515-8.Disclosure of Interests:None declared

scholarly journals Solitary coronary artery: An unusual cause of atypical chest pain

2019 ◽  
Vol 16 (1) ◽  
pp. 55-56
Author(s):  
Laxman Dubey ◽  
Ridhi Adhikari ◽  
Suresh Deep
Keyword(s):  
Computed Tomography ◽  
Congenital Anomaly ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Sinus ◽  
Sinus Of Valsalva ◽  
Atypical Chest Pain ◽  
Rare Congenital Anomaly ◽  
The Right

Coronary arteries arising from single coronary sinus is a rare congenital anomaly. We report a 30-year-old male who presented with atypical chest pain and computed tomography coronary angiography revealed a solitary coronary artery originating from a single ostium in the right sinus of Valsalva. 

scholarly journals The prevalence of coronary artery anomalies in adults: Studied with computed tomography coronary angiography

2018 ◽  
Vol 75 (1) ◽  
pp. 16-22
Author(s):  
Dragana Ilic ◽  
Dragan Stojanov ◽  
Goran Koracevic ◽  
Sladjana Petrovic ◽  
Zoran Radovanovic ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Coronary Sinus ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Therapeutic Treatment ◽  
Circumflex Artery ◽  
Left Circumflex Artery

Background/Aim. Coronary artery anomalies are an uncommon but important cause of chest pain, and in some cases of hemodynamically significant abnormalities, sudden cardiac death. The aim of the research was to establish the prevalence of the coronary arteries anomalies in our population. Methods. The study group included 1,562 patients (810 men, 752 women, average age 64.3 ? 12.0 years; range 32?80 years) who were scheduled for 64-slice computed tomography (MSCT), which enables detailed visualization of coronary arteries and heart anatomy. All examinations were made due to suspicion (atypical chest pain, angina equivalent symptoms or multiple risk factors for cardiovascular disease) or assumption of progression of coronary artery disease. Results. From January 2010 till December 2014 a total number of 1,562 patients were sent for evaluation of coronary arteries. The coronary anomalies were found in 45 (2.88%) patients. The most frequent coronary anomaly seen in our population group was absence of left main trunk with the separate origin of the left anterior descending artery (LAD) and left circumflex artery (LCx) originating from a left coronary sinus (LCS). This was found in 12 patients (an incidence of 0.77% or 26.7% of all coronary anomalies). Anomalous location of coronary ostium outside normal aortic sinuses in our study was present as right coronary artery (RCA) that arises from left anterior sinus in 5 (0.32%) patients and left coronary artery from non-coronary sinus in two (0.13%) patients. Conclusion. Knowledge of anomalies of the coronary arteries and their recognition on the multislice computed tomography is of great importance for the further planning of a possible therapeutic treatment. Coronary anomalies that are considered insignificant will require no further therapeutic treatment. But the detection of malignant coronary anomalies will certainly save many lives.

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