Chest Pain ; etiology ; Coronary Vessel Anomalies ; complications ; diagnostic imaging ; Female ; Humans ; Middle Aged ; Tomography, X-Ray Computed

No abstract available.
Aged ; Angina Pectoris/diagnosis/etiology ; Coronary Angiography ; Coronary Artery Disease/*complications/diagnosis/therapy ; Coronary Stenosis/*complications/diagnosis/therapy ; Coronary Vessel Anomalies/*complications/diagnosis ; Humans ; Male ; Percutaneous Coronary Intervention/instrumentation ; Stents ; Treatment Outcome

Adult ; Coronary Vessel Anomalies ; complications ; Death, Sudden ; Fatal Outcome ; Humans ; Male ; Myocardial Bridging ; complications

Acute Disease ; Adolescent ; Coronary Angiography ; Coronary Sinus ; abnormalities ; diagnostic imaging ; Coronary Vessel Anomalies ; complications ; diagnostic imaging ; Electrocardiography ; Female ; Humans ; Myocardial Infarction ; diagnostic imaging ; etiology ; Tomography, X-Ray Computed

Aged ; Angioplasty, Balloon ; Coronary Vessel Anomalies ; complications ; therapy ; Humans ; Male ; Middle Aged ; Mobility Limitation ; Stents

Although the majority of coronary artery anomalies are found incidentally and not clinically significant, the interarterial course between the major vessels of the aberrant artery may be responsible for syncope, angina, arrhythmias or sudden death. There are only a few case reports describing the origination of all the coronary arteries from a single ostium. This anomaly occurs in only 0.024%-0.044% of the population. Left coronary artery originating from the right coronary is a rare coronary abnormality. Here we report a case of acute myocardial infarction in a patient with anomalous left coronary artery originating from the right coronary artery, as was confirmed by computerized tomography angiogram, which showed that only one single coronary artery stem originating from the right sinus of Valsalva trifurcated into a right coronary artery, left circumflex artery and a hypoplastic left anterior descending artery. Subsequent percutaneous coronary intervention (PCI) procedures were performed successfully. PCI procedures should be carried out with great caution in such cases, and this condition should be managed as a left main lesion.
Coronary Angiography ; methods ; Coronary Vessel Anomalies ; complications ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; diagnostic imaging ; therapy ; Percutaneous Coronary Intervention

Coronary artery anomalies are associated often with myocardial ischemia or sudden cardiac death. A 19-year-old woman who participated in an exertive game lost consciousness upon one such exertion. She was taken to a hospital where she died on the same day. An autopsy revealed that she had bifurcated coronary arteries, which arose from one coronary ostium in the left sinus of Valsalva. The right coronary artery arose from the left sinus and traveled between the aorta and the pulmonary trunk. The heart as well as the cardiac conduction system depended exclusively on the single coronary artery ostium for oxygenated blood supply, and the unbalanced blood distribution on her exertion probably led to sudden cardiac death. The case highlights the medicolegal importance of unexpected sudden cardiac death related to an anomalous origin of the coronary arteries.
Autopsy ; Coronary Vessel Anomalies/*complications/pathology ; Coronary Vessels/pathology ; Death, Sudden, Cardiac/*etiology/pathology ; Female ; Humans ; Physical Exertion ; Sinus of Valsalva/abnormalities ; Young Adult

INTRODUCTIONThe objective of this case report was to illustrate the diagnostic and intervention approach of anomalous right coronary artery (RCA).

CLINICAL PICTUREA 60-year-old man presented with acute inferior myocardial infarction. Cardiac catheterisation revealed an anomalous RCA arising from the posterior coronary sinus as the infarct-related artery.

TREATMENTAd hoc percutaneous coronary intervention with stent implantation was performed using a few technical modifications.

OUTCOMEGood angiographic result was achieved within 90 minutes, with 260 mL of contrast used.

CONCLUSIONA high index of suspicion and logical diagnostic and intervention approach are required for the proper management of anomalous RCA.

Angioplasty, Balloon, Coronary ; Cardiac Catheterization ; methods ; Coronary Angiography ; Coronary Vessel Anomalies ; complications ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; surgery

PURPOSE: Four pediatric patients with congenital coronary arteriovenous fistula (CAVF) were reported to remind pediatric practitioners and cardiologists of its diagnosis and management. MATERIALS AND METHODS: Four pediatric patients with congenital CAVF from June 1999 to November 2007 were included in this retrospective study. Study modalities included reviews of patients' profiles of clinical features, chest radiograph, Doppler echocardiography, cardiac catheterization with angiography, myocardial perfusion scan, and computed tomography. RESULTS: All 4 patients were symptomatic. The clinical symptoms and signs were feeding problem, continuous murmur, tachycardia, tachypnea, cardiomegaly, and exertional chest pain. Myocardial enzyme was elevated in 1 patient. Echocardiography showed dilatation of the coronary artery in all 4 patients, and traced down its origin in 3 and drainage in 4. The fistulas originated from the right coronary artery in 2 patients and left coronary artery in 2, and were drained into the right ventricle in 2, right atrium in 1, and pulmonary artery in 1. Single left coronary artery was found in 1 patient. The pulmonary-to-systemic blood flow ratios ranged from 1.2 to 2.5. Transcatheter coil occlusion was successfully performed in 4 patients through a coaxial delivery system. The symptoms and signs of congestive heart failure and myocardial ischemia disappeared after the procedure. CONCLUSION: Diagnosis of congenital CAVF could be achieved by appreciation of continuous murmur over area unusual for the ductus, and by scrupulous examination of echocardiography as well as angiography of the coronary artery through which coaxial transcatheter coil occlusion could be performed successfully.
*Arteriovenous Fistula/complications/radiography/therapy ; Child ; Child, Preschool ; Coronary Angiography ; Coronary Circulation ; *Coronary Vessel Anomalies/complications/radiography/therapy ; *Embolization, Therapeutic ; Female ; *Heart Failure/etiology/radiography/therapy ; Humans ; Infant ; Male ; *Myocardial Ischemia/etiology/radiography/therapy

Arrhythmogenic Right Ventricular Dysplasia ; complications ; Autopsy ; Cardiomyopathy, Hypertrophic ; complications ; Cause of Death ; Coronary Disease ; complications ; Coronary Vessel Anomalies ; complications ; Death, Sudden, Cardiac ; etiology ; pathology ; Humans