Congenital coronary artery anomalies in adults: review of 111 cases from a single-centre experience

2016 ◽  
Vol 27 (6) ◽  
pp. 1041-1050
Author(s):  
Yiğit Çanga ◽  
Tolga S. Güvenç ◽  
Mehmet B. Karataş ◽  
Ali N. Çalık ◽  
Tolga Onuk ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Wide Spectrum ◽  
Final Diagnosis ◽  
Coronary Anomaly ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Tertiary Referral Centre ◽  
Artery Disease ◽  
Coronary Angiograms

AbstractBackgroundCoronary artery anomalies are a heterogeneous group of congenital disorders presenting with a wide spectrum of symptoms, ranging from vague chest pain to sudden cardiac death. Despite available data, there is no consensus about the classification, nomenclature, and outcomes of coronary anomalies in the normally connected heart. In this study, we aimed to investigate clinical and angiographic characteristics of coronary arterial anomalies, as well as the frequency of atherosclerotic involvement in anomalous coronaries, diagnosed at a tertiary referral centre.MethodsWe retrospectively reviewed coronary angiograms performed between 2011 and 2015 for the presence of a coronary anomaly. A total of 111 patients with a final diagnosis of coronary anomaly were included in the study group. We also recruited 110 age- and sex-matched patients who underwent coronary angiography because of symptomatic coronary artery disease as controls.ResultsAmong 36,893 coronary angiograms, 111 (0.30%) major coronary anomalies were found. Compared with controls, the prevalence of significant atherosclerotic coronary disease was lower in patients with coronary anomalies and stable symptoms (p=0.02); however, the prevalence of significant coronary atherosclerosis was similar among patients admitted with unstable angina or myocardial infarction (p>0.05). Compared with controls, patients with an anomalous left anterior descending coronary artery had significantly less atherosclerotic involvement than those in whom the left anterior descending artery was not anomalous (p=0.005).ConclusionsAlthough coronary artery anomalies are cited as a cause for myocardial ischaemia, atherosclerotic coronary artery disease is also frequent and may offer an alternative explanation to ischaemic symptoms. No predisposition to accelerated atherosclerosis was found, however, and atherosclerotic involvement was less frequent in some anomalous vessels.

scholarly journals Coronary artery anomalies in North Indian population: a conventional coronary angiographic study

2017 ◽  
Vol 06 (04) ◽  
pp. 250-257
Author(s):  
Yogesh Diwan ◽  
Deepa Diwan ◽  
Randhir S. Chauhan ◽  
Prakash C. Negi
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Indian Population ◽  
Tertiary Care ◽  
Clinical Aspects ◽  
Single Coronary Artery ◽  
North Indian Population ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Artery Disease

Abstract Background: Anomalies of origin and course of one or both coronary arteries, with or without symptoms, are of special interest for anatomists, interventional cardiologists, and cardiac surgeons. Aims: To estimate the prevalence of coronary anomalies and their clinical aspects in North Indian population. Material and Methods: Study was done on patients undergoing coronary angiography for suspected coronary artery disease or for coronary intervention at a tertiary care centre in North India. Results: A total of 1130 patients [803 males, 327 females and mean age 57.37°10.60 years] were reviewed for coronary artery anomalies. Overall incidence of Coronary artery anomalies was 13 [1.15%] and was 1% in men and 1.53% in women. 38.46% of these patients were found to have ectopic origin of left circumflex [LCx] and in 23.08% of cases, ectopic origin of right coronary artery [RCA] was noted. Separate orifice for left anterior descending [LAD] and LCx in left coronary sinus [LCS] was observed in 0.27% cases, coronary artery fistula [CAF] in 0.09% cases and single coronary artery from LCS was found in 0.09% cases. Conclusions: The most common coronary anomalies were origin of LCx from RCA and presence of separate orifice for LAD and LCx in LCS. Dominance, gender and coronary artery disease [CAD] have no association with coronary anomalies.

scholarly journals Difference in the Mortality Between Weekend and Non-Weekend Coronary Artery Disease Admissions

2017 ◽  
Vol 02 (01) ◽  
pp. 036-041
Author(s):  
M. Sandeep ◽  
K. Satish
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Risk Score ◽  
Wide Spectrum ◽  
P Value ◽  
Coronary Artery Diseases ◽  
Coronary Syndrome ◽  
Artery Disease

AbstractBackground: Acute coronary syndrome requires urgent diagnostic and therapeutic procedures, which may not be uniformly available throughout the week. So, we sought to examine the effects of admission on clinical outcomes in patients with wide spectrum coronary artery diseases.Methods: A retrospective analysis of ICCU Inpatient sample database of 17 months from 2015 to 2016 used to compare differences in in-hospital mortality between patients admitted on a non-weekday versus weekend for wide spectrum ACS which include STEMI, NSTEMI and unstable angina and patients with cardiogenic shock. Out of these 75% had higher TIMI risk score (5-7).Results: Total 2700 patients with ACS were included in the present study with wide spectrum coronary artery diseases. Out of that 20 % (n=541) were admitted in weekends and 79.9% (n=2159) were admitted in non-weekends. Total 804 females admitted on non-weekend had a mean age of 61.05±12 years and 162 females admitted on weekend had mean age 58.5±13.3 years (p value=0.025). Out of 2159 admitted on non-weekend, 1355 were males with mean age of 57.65±15.55 years and 379 were males admitted on weekend out of 541 patients with mean age of 56.85±13.1 years (p value =0.314). In-hospital mortality rate of these patients admitted on non-weekends was 9.4% (n=204) and those admitted on weekends was 5.9% (n=32) with statistically significant difference (95% CI; p= 0.003). The mortality rate of ACS without STEMI in non-weekend group was 8.6% (n=170) which was statistically significant (p = 0.006) with mortality of weekend group 5.3% (n=26).Conclusion: Our study shows that there is no added mortality in patients with coronary artery disease on weekend days compared with non-weekend days. As the patients admitted during non-weekend were elder and sicker than the weekend admissions (having the high risk score), the in-hospital mortality is higher on non-weekends. Efforts to improve health care system should ensure comparable outcomes for patients irrespective of time of hospital admission.

Familial clustering of cardiac conditions in patients with anomalous aortic origin of a coronary artery and myocardial bridges

2018 ◽  
Vol 28 (9) ◽  
pp. 1099-1105 ◽  
Author(s):  
Hitesh Agrawal ◽  
Carlos M. Mery ◽  
S. Kristen Sexson Tejtel ◽  
Charles D. Fraser ◽  
E. Dean McKenzie ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Arrest ◽  
Coronary Artery ◽  
Family History ◽  
Positive Family History ◽  
Sudden Cardiac Arrest ◽  
Coronary Anomalies ◽  
Myocardial Bridge ◽  
Familial Clustering ◽  
Artery Disease

AbstractBackgroundAnomalous aortic origin of a coronary artery is the second leading cause of sudden cardiac arrest/death in young athletes in the United States of America. Limited data are available regarding family history in this patient population.MethodsPatients were evaluated prospectively from 12/2012 to 02/2017 in the Coronary Anomalies Program at Texas Children’s Hospital. Relevant family history included the presence of CHD, sudden cardiac arrest/death, arrhythmia/pacemaker use, cardiomyopathy, and atherosclerotic coronary artery disease before the age of 50 years. The presence of one or more of these in 1st- or 2nd-degree relatives was considered significant.ResultsOf 168 unrelated probands (171 patients total) included, 36 (21%) had significant family history involving 19 (53%) 1st-degree and 17 (47%) 2nd-degree relatives. Positive family history led to cardiology referral in nine (5%) patients and the presence of abnormal tests/symptoms in the remaining patients. Coronary anomalies in probands with positive family history were anomalous right (27), anomalous left (five), single right coronary artery (two), myocardial bridge (one), and anomalous circumflex coronary artery (one). Conditions present in their family members included sudden cardiac arrest/death (15, 42%), atherosclerotic coronary artery disease (14, 39%), cardiomyopathy (12, 33%), CHD (11, 31%), coronary anomalies (3, 8%), myocardial bridge (1, 3%), long-QT syndrome (2, 6%), and Wolff–Parkinson–White (1, 3%).ConclusionIn patients with anomalous aortic origin of a coronary artery and/or myocardial bridges, there appears to be familial clustering of cardiac diseases in approximately 20% of patients, half of these with early occurrence of sudden cardiac arrest/death in the family.

scholarly journals Relationship between significant coronary artery disease and coronary artery anomalies

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P5679-P5679
Author(s):  
H. U. Yazici ◽  
A. Birdane ◽  
Y. Aydar ◽  
T. Ulus ◽  
U. Senol ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Significant Coronary Artery Disease ◽  
Coronary Artery Anomalies ◽  
Artery Disease
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