A rare coronary anomaly unmasked by ST abnormalities on 24-h Holter: a case report (original) (raw)
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Anomalous origin of the left coronary artery from the right sinus of Valsalva, even though rare, has been documented well in literature. However the association of this anomaly with coronary fistulae has been rarely reported so far. We report the case of a 76-year-old female who presented to us with exertional dyspnoea. General physical and cardiovascular examination revealed no significant abnormalities. All laboratory investigations were normal. Chest radiograph was normal. Electrocardiogram showed left bundle branch block. Echocardiogram revealed a globally hypokinetic left ventricle with reduced ejection fraction. Coronary angiogram showed anomalous origin of left coronary artery from right coronary sinus along with a small coronary-cameral fistula connecting obtuse marginal artery to left ventricle, there was no significant stenosis of epicardial coronaries. This case report, documents the rare association of an anomalous coronary origin of left coronary artery with coronary fi...
Ventricular Tachycardia due to Anomalous Origin of Right Coronary Artery
The Internet Journal of Cardiology, 2012
Coronary anomalies are observed in 0.8 to 1% of patients on angiography and about 8% of these occur in Right coronary artery (RCA). Anomalous origin of RCA from left coronary sinus (AORCALS) can cause myocardial ischemia, arrhythmia, syncope and sudden cardiac death (SCD). We report a case of AORCALS presenting as exercise induced ventricular tachycardia (VT). A 48 year old Afro-American female with no known cardiac history presented with exertional palpitations and associated atypical exertional chest pain for couple of months. Dobutamine stress echocardiogram showed normal left ventricular structure and systolic function with mild reversible inferior wall ischemia. An event monitor revealed non sustained monomorphic ventricular tachycardia (VT). Coronary angiogram revealed RCA originating from the left coronary cusp without any significant luminal stenosis. . Further evaluation of RCA course with cardiac CT angiography or MRI was recommended. She declined any further invasive test...
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Coronary artery anomalies arising from the opposite sinus of Valsalva and having an interarterial course between the aorta (AO) and pulmonary artery (PA) are the second most common cause of sudden cardiac death among young athletes, after hypertrophic cardiomyopathy. The right coronary artery (RCA) originating from the AO above the left sinus of Valsalva (LSV) is an extremely rare anomaly. We report the first case of a RCA arising from the AO above the LSV that subsequently runs between the AO and the PA, discovered by a 64-slice multidetector coronary CT, in a patient who was successfully resuscitated from ventricular fibrillation (VF) cardiac arrest while running in a marathon race.
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Coronary anomalies are the cause of 12% of sudden deaths among athletes. Similarly anomalous coronary origin from the opposite sinus is often found at autopsy. The use of echocardiography to screen for these types of defects may provide a potentially life-saving diagnosis. The authors present a case that highlights the utility of echocardiography as part of a comprehensive screening program for athletes.
A life-threatening association of coronary anomalies
Journal of Clinical and Scientific Research, 2016
Anomalous origin of the left coronary artery from the right sinus of Valsalva, even though rare, has been documented well in literature. However the association of this anomaly with coronary fistulae has been rarely reported so far. We report the case of a 76-year-old female who presented to us with exertional dyspnoea. General physical and cardiovascular examination revealed no significant abnormalities. All laboratory investigations were normal. Chest radiograph was normal. Electrocardiogram showed left bundle branch block. Echocardiogram revealed a globally hypokinetic left ventricle with reduced ejection fraction. Coronary angiogram showed anomalous origin of left coronary artery from right coronary sinus along with a small coronary-cameral fistula connecting obtuse marginal artery to left ventricle, there was no significant stenosis of epicardial coronaries. This case report, documents the rare association of an anomalous coronary origin of left coronary artery with coronary fistula.
Heart and Vessels, 2005
Cardiac arrest in a soccer player: a unique case of anomalous coronary origin detected by 16-row multislice computed tomography coronary angiography His ventriculogram showed a preserved left ventricular systolic function with discrete anterolateral and diaphragmal hypokinesia. The dominant right coronary artery (RCA) showed a localized dissection in its proximal segment without any impact on flow . The left anterior descending artery (LAD) describing an "anterior dot sign," the circumflex (Cx), and a small septal branch arose with separate ostia from the right coronary sinus.
European Journal of Preventive Cardiology
The aim of the accompanying comments is to help clarify the objectives, methods and policy decisions involved in screening young athletes in order to prevent sudden cardiac death (SCD) due to coronary artery anomalies (CAAs). This information is provided as a commentary to the article published in the current issue of the journal by Gerling et al. 1 Coronary artery anomalies are a special issue in sports-related screening. The definitions, anatomofunctional features and treatments for these congenital defects are often vaguely specified. 2,3 Physicians should consider CAAs not only in terms of how they are anatomical exceptions to the rules (anatomical variants) but, more importantly, in terms of their functional behavior during strenuous exertion at the time of training and/or competing. The clinical manifestations of CAAs are rarely seen in sedentary individuals.