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Cardiology
Published in Fazal-I-Akbar Danish, Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Sudden death in a young elite athlete:1 Cardiac causes: a Muscle pathology (HOCM [50%]; arrhythmogenic right ventricular cardiomyopathy; myocarditis).b Vasculopathy (coronary artery anomaly).c Valvular pathology (MVP).d WPW syndrome; LQTS.e Drug abuse.2 Non-cardiac causes: a Rhabdomyolysis.b Heat stroke.c Sarcoidosis.
Congenital coronary artery anomalies
Published in Jana Popelová, Erwin Oechslin, Harald Kaemmerer, Martin G St John Sutton, Pavel Žáček, Congenital Heart Disease in Adults, 2008
Jana Popelová, Erwin Oechslin, Harald Kaemmerer, Martin G St John Sutton, Pavel Žáček
In adulthood, congenital coronary artery anomalies represent more often as an incidental finding rather than the cause of clinical complaints. However, in some cases, congenital coronary anomalies may cause atypical chest pains, anginal pain, arrhythmias, sudden death or heart failure, even in adulthood. But the majority of patients don’t have a characteristic presentation and remain asymptomatic for a large portion of their lives. Normal coronary artery origins can be visualized in adults by transesophageal echocardiography (Figures 18.1 and 18.2). Coronary artery anomaly is defined as origin of a coronary artery from an ectopic position in the aorta.
Coronary anomaly: when you think you've seen it all
Published in Acta Cardiologica, 2019
W. Holvoet, C. Mihl, A. W. Ruiters, B. L. J. H. Kietselaer, S. C. A. M. Bekkers
A 71-year old man known with hypertension presented with progressive dyspnoea on exertion. Because of global and mild left ventricular (LV) systolic dysfunction on echocardiography, invasive coronary angiography (ICA) was performed. Although obstructive coronary artery disease was ruled out, an unusual coronary artery anomaly (CAA) was revealed. The right coronary artery (RCA) originated from the left sinus of Valsalva giving off a left anterior descending (LAD) and circumflex artery (Cx) (Figure 1, panel A–B). A second LAD giving off a diagonal (D) and septal (S) branch originated from a separate ostium also in the left sinus of Valsalva (panel C). Computed tomographic coronary angiography (CTCA) showed a subpulmonic course (between aorta and right ventricular outflow tract) of the RCA, a retro-aortic course of its Cx and pre-pulmonic course of its LAD (panel D–F). Besides an acute angle take-off, no other malignant features of the aberrant RCA were present. Because additional dobutamine-stress echocardiography was normal, he was managed conservatively with antihypertensive medication only. LV systolic function normalised after seven months.
Acute coronary syndrome in a patient with single coronary artery and double left anterior descending artery coexistence: a case report of an extremely rare congenital coronary artery anomaly
Published in Acta Cardiologica, 2022
Christos Graidis, Aggeliki Mavrogianni, Dimokritos Dimitriadis, Georgios Dimitriadis, Tatiana Christoforidou, Vasileios Karasavvidis, Maria Oikonomou, Spyridon Graidis, Aikaterini Vasiliki Touriki
The patient underwent coronary angiography, but the left coronary system could not be visualised. Therefore, aortography was carried out, which showed the whole coronary network originating from a single ostium in the right sinus of Valsalva (Figure 1). The single ostium was selectively catheterised and three major vessels were outlined along with the anatomical details of the congenital coronary artery anomaly (Figure 2). Then, a 64-slice CT angiography was performed and depicted the coexistence of single coronary artery (SCA) and double LAD type IV and it gave additional information regarding the coronary arteries’ path (Figure 3). The patient was treated conservatively and was advised to undergo a single photon emission computed tomography (SPECT).