Ischaemic heart disease: coronary artery anomalies

2016 ◽  
Author(s):  
Eugenio Picano ◽  
Fausto Pinto ◽  
Blazej Michalski
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Cardiac Death ◽  
Incidental Finding ◽  
Superior Vena ◽  
Vena Cava ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Venous Structure ◽  
Coronary Artery Segment

Coronary anomalies occur in less than 1% of the general population and their clinical presentation can range anywhere from a benign incidental finding to the cause of sudden cardiac death. Since congenital coronary arteries anomalies are often considered as the first cause of cardiac death in young athletes in Europe, careful attention has to be paid in this specific subpopulation in case of suggestive symptoms. Although focused expert echocardiography is the first-line imaging tool, coronary computed tomography or radiation-free magnetic resonance imaging are recommended for more definitive definition of the coronary course in persons suspected of having coronary artery anomalies. Most coronary anomalies belong to the group of anomalous origin. Aneurysms are defined as dilations of a coronary vessel 1.5 times the normal adjacent coronary artery segment. Coronary artery fistulas are communications between one or more coronary arteries and a cardiac chamber (coronary-cameral), the pulmonary artery, or a venous structure (such as the sinus or superior vena cava).

Management and Anesthetic Considerations for Patients With Anomalous Aortic Origin of a Coronary Artery

2018 ◽  
Vol 22 (4) ◽  
pp. 383-394 ◽  
Author(s):  
Benjamin Kloesel ◽  
Martina Richtsfeld ◽  
Mojca Konia ◽  
John L. Bass
Keyword(s):  
Coronary Artery ◽  
Risk Stratification ◽  
Coronary Arteries ◽  
Anesthetic Management ◽  
Heterogeneous Group ◽  
Coronary Anomalies ◽  
Disease Group ◽  
Coronary Artery Anomalies ◽  
Fatal Disease ◽  
Anesthetic Considerations

The term “coronary artery anomalies” encompasses a large and heterogeneous group of disorders that may affect origin, intrinsic anatomy, course, location, and termination of the coronary arteries. With these different anatomies, presentation, symptoms, and outcomes are heterogeneous as well. While significant efforts are directed toward improving diagnosis and risk-stratification, best evidence-guided practices remain in evolution. Data about anesthetic management of patients with coronary anomalies are lacking as well. This review aims to provide the anesthesiologist with a better understanding of an important subgroup of coronary artery anomalies: anomalous aortic origin of a coronary artery. We will discuss classification, pathophysiology, incidence, evaluation, management, and anesthetic implications of this potentially fatal disease group.

scholarly journals A Rare Coronary Artery Anomaly: Origin of All Three Coronary Arteries from the Right Sinus of Valsalva

2015 ◽  
Vol 5 ◽  
pp. 25 ◽  
Author(s):  
Lale Pasaoglu ◽  
Ugur Toprak ◽  
Emre Nalbant ◽  
Gokhan Yagiz
Keyword(s):  
Coronary Artery ◽  
Sudden Cardiac Death ◽  
Coronary Arteries ◽  
Cardiac Death ◽  
Sinus Of Valsalva ◽  
Coronary Artery Anomalies ◽  
Non Invasive ◽  
Life Threatening ◽  
The Right ◽  
Aberrant Vessels

Left anterior descending (LAD) artery and left circumflex (LCx) coronary artery originating separately from the right sinus of valsalva is exceptionally rare and very few cases have been reported in the literature. Congenital coronary artery anomalies are generally incidental, uncommon, and asymptomatic. Some can cause severe potentially life-threatening symptoms such as myocardial ischemia and sudden cardiac death. The aberrant vessels that pass between the aorta and the pulmonary trunk pose a risk of sudden cardiac death, particularly if the vessel supplies the left coronary artery network. The electrocardiographically gated multi-detector computed tomography (MDCT) allows accurate and non-invasive depiction of coronary artery anomalies including origin, course, and termination. We report here a rare case of all three coronary arteries separately originating from the right coronary sinus, which was detected with MDCT.

scholarly journals Unduly long left main (79 mm) coronary artery arising from right coronary sinus in a 64-year-old diabetic man

2019 ◽  
Vol 12 (7) ◽  
pp. e229815
Author(s):  
Santosh Kumar Sinha ◽  
Puneet Aggarwal ◽  
Mahmodula Razi ◽  
Vinay Krishna
Keyword(s):  
Coronary Artery ◽  
Coronary Sinus ◽  
Cardiac Death ◽  
Left Main Coronary Artery ◽  
Incidental Finding ◽  
Coronary Angiogram ◽  
Exertional Dyspnoea ◽  
Coronary Artery Anomalies ◽  
Left Main ◽  
Extensive Search

Coronary artery anomalies are usually an incidental finding on coronary angiogram. Most of them are benign, although few of them are malignant which may cause sudden cardiac death. A 64-year-old diabetic, hypertensive man underwent coronary angiography for evaluation of exertional dyspnoea, and angina which revealed an anomalous left main coronary artery (LMCA) arising from right coronary sinus which was unduly long (79 mm) but free from any disease. To the best of our knowledge after extensive search in literature, this is the longest LMCA to be ever reported. The patient was managed conservatively.

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.

scholarly journals Frequency of Coronary Artery Anomalies in patients undergoing Coronary Angiography.

2020 ◽  
Vol 27 (02) ◽  
pp. 377-380
Author(s):  
Imran Javaid ◽  
Muhammad Akram ◽  
Shahbaz Amjad ◽  
Rehan Riaz ◽  
Ali Ehsan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Incidental Finding ◽  
Cross Sectional Study ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Cross Sectional ◽  
The Mean ◽  
And Function ◽  
Study Setting

Coronary artery anomalies are abnormalities in coronary arteries by birth (congenital) and involve their anatomy, course and function. They usually occur in association with other congenital cardiac defects. Coronary artery anomalies are usually clinically silent as they do not cause symptoms and are found incidentally but relatively few become evident by causing symptoms. Objectives: Determine the frequency of coronary artery anomalies in patients undergoing coronary angiography. Study Design: Cross sectional study. Setting: Faisalabad Institute of Cardiology, Faisalabad. Period: From July to December 2017. Material & Methods: Demographic information from all the patients was recorded and all of these individuals were undergone coronary angiography. All the collected data was analyzed by SPSS. Results: The mean age of the patients was 43.74 ± 15.35 years, male and female patients were equal in number. In this study coronary anomalies were present in 28(4.06%) patients. Conclusion: Coronary artery anomalies are found quite frequently but usually are incidental finding.

scholarly journals Coronary anomalies and anatomical variants detected by coronary computed tomographic angiography in Kashmir, India

2020 ◽  
Vol 8 (2) ◽  
pp. 584
Author(s):  
Suhail Rafiq ◽  
Irshad Mohiuddin ◽  
Imran Nazir ◽  
Malik Faizan
Keyword(s):  
Coronary Artery ◽  
Cardiac Death ◽  
Computed Tomographic Angiography ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Coronary Cta ◽  
Coronary Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Anomalous Coronary

Background: Coronary Artery Anomalies (CAAs) presenting in adulthood are rare and associated with adverse cardiac events, including sudden cardiac death. Coronary artery anomaly is the second most common cause of Sudden Cardiac Death (SCD) in young athletes. Cardiac Computed Tomographic Angiography (CTA) is a readily available non-invasive imaging modality that provides high-resolution anatomical information of the coronary arteries. Multi-detector row CT is superior to conventional angiography in defining the ostial origin and proximal path of anomalous coronary branches.Methods: This was a prospective study included 186 patients who underwent coronary CTA from December 2018 to November 2019 in Government medical College, Srinagar on a 256 slice CT. The indications for coronary CTA were an equivocal, or non-diagnostic stress test, atypical chest pain, suspected anomalous coronary, as well as the evaluation of cardiac cause of syncope.Results: Ramus intermedius was the most common anatomical variant seen in 25 patients (13.4%). The prevalence of coronary anomalies in this study was 5.66% including myocarding bridging. The most common anomaly was high take off of coronary artery from sinotubular junction accounting for 1.6%.Conclusions: Coronary Computed Tomographic angiography is much superior in detecting coronary artery anomalies than invasive coronary angiography because of the absence of soft tissue information like as is needed in myocardial bridging. Proper knowledge of the anomalies and their clinical significance is highly important in planning treatment and easing hardships of cardiologists in dealing with them.

scholarly journals Triphasic Contrast Agent Injection in 64-MDCT Coronary Artery Angiography

2014 ◽  
Vol 4 (1) ◽  
pp. 12-22
Author(s):  
C Missiroli ◽  
Y Kim ◽  
S Shankar ◽  
J Chun ◽  
H Shin ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Superior Vena ◽  
Vena Cava ◽  
Region Of Interest ◽  
Asymptomatic Patients ◽  
Streak Artifacts ◽  
The Right

Purpose: To evaluate image quality and cardiovascular enhancement after triphasic injection in 64-slice-CT coronary angiography (c-CTA). Methods: c-CTA of twenty-two asymptomatic patients following triphasic injection (65ml-contrast bolus + mixed 30ml-contrast and 20ml-saline bolus + 50ml-saline chaser) were retrospectively reviewed. Attenuation in the great vessels, cardiac chambers, and coronary arteries in 13 places were measured by region of interest. Also, differences in enhancement between the right coronary artery (RCA) and the right cardiac chambers (RCA versus right atrium or RA; RCA versus right ventricle or RV) were analyzed. Quality of images and contrast-related streak artifacts were subjectively assessed by 2 radiologists in consensus on a 4-point scale. Results: There was excellent enhancement in the coronary arteries (mean range 395.84-429.90 Hounsfield Units or HU), ascending aorta (mean 448.58 HU), descending aorta (mean 433.49 HU), and pulmonary artery (mean 385.45 HU). There was adequate difference in attenuation between RCA versus RA (mean range 126.12-148.43 HU) and RCA versus RV (mean range 50.34-72.66 HU). There was high and inhomogeneous attenuation in the superior vena cava (mean 509.23 HU). The quality of images was considered good (mean 1.6; 1 = excellent, 2 = good, 3 = moderate, 4 = low) and contrast-related streak artifacts were considered low (mean 2.9; 1 = severe, 2 = moderate, 3 = low, 4 = absent) by two radiologists. Conclusions: Our triphasic contrast injection provides excellent cardiovascular enhancement with minimal contrast-related streak artifacts, particularly in the right cardiac chambers while adequately differentiating the right coronary artery. DOI: http://dx.doi.org/10.3126/njr.v4i1.11365 Nepalese Journal of Radiology, Vol.4(1) 2014: 12-22

Epidemiology of coronary abnormalities of discharge and branching and their clinical significance

2019 ◽  
Vol 22 (6) ◽  
pp. 40-50
Author(s):  
E. F. Abbasov ◽  
S. S. Manafov ◽  
F. Z. Abdullayev ◽  
F. E. Abbasov ◽  
A. G. Akhundova
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
World Literature ◽  
Incidence Rates ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Coronary Abnormalities ◽  
Magnetic Resonance Imaging Mri ◽  
Age Range ◽  
Living Person

Purpose.Until the mid-20th century they could be discovered only during autopsy, it means after death. With the introduction of coronary angiography it become possible to find them in a living person. Later on, new modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) enhanced futher our abilities. It is very important to discover coronary anomalies in a living person, because some of them could lead to sudden cardiac death (SCD). In fact, coronary artery anomalies are the second main cause of the SCD in young athletes. Another importance is driven by the fact, that some of them could lead to lifethreatening complications during cardiac surgery when unknown before the operation.Methods.We prospectively reviewed all coronary angiography films from 2011 to 2016 in our center. Coronary anomalies were reviewed and classified by two independent experienced operators. Patients with congenital heart disease and coronary fistulas were excluded.Results.Out of 5055 patients 148 (2.9%) had coronary artery anomalies of origin and distribution. Those were 120 men (81.1%) and 28 women (18.9%) with an age range between 29 to 88 years. The three most common anomalies were myocardial bridge (48.7%), separate origin of the conus branch (13.5%) and separate origin of the LAD and LCX (8.1%).Conclusion.In our study we found more or less the same types and incidence rates of coronary artery anomalies as in the world literature. We had apparently higher rates of myocardial bridges, compared to average number on angiography studies, but very close to authopsy study rates.

Paediatric-onset coronary artery anomalies in pregnancy: a single-centre experience and systematic literature review

2017 ◽  
Vol 27 (8) ◽  
pp. 1529-1537 ◽  
Author(s):  
Michelle Keir ◽  
Catriona Bhagra ◽  
Debra Vatenmakher ◽  
Francisca Arancibia-Galilea ◽  
Katrijn Jansen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Arrest ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Major Cardiovascular Events ◽  
Coronary Aneurysms ◽  
Increased Risk ◽  
In Pregnancy

AbstractObjectivesIndividuals with childhood-onset coronary artery anomalies are at increased risk of lifelong complications. Although pregnancy is thought to confer additional risk, a few data are available regarding outcomes in this group of women. We sought to define outcomes of pregnancy in this unique population.MethodsWe performed a retrospective survey of women with paediatric-onset coronary anomalies and pregnancy in our institution, combined with a systematic review of published cases. We defined paediatric-onset coronary artery anomalies as congenital coronary anomalies and inflammatory arteriopathies of childhood that cause coronary aneurysms. Major cardiovascular events were defined as pulmonary oedema, sustained arrhythmia requiring treatment, stroke, myocardial infarction, cardiac arrest, or death.ResultsA total of 25 surveys were mailed, and 20 were returned (80% response rate). We included 46 articles from the literature, which described cardiovascular outcomes in 82 women (138 pregnancies). These data were amalgamated for a total of 102 women and 194 pregnancies; 59% of women were known to have paediatric-onset coronary artery anomalies before pregnancy. In 23%, the anomaly was unmasked during or shortly after pregnancy. The remainder, 18%, was diagnosed later in life. Major cardiovascular events occurred in 14 women (14%) and included heart failure (n=5, 5%), myocardial infarction (n=7, 7%), maternal death (n=2, 2%), cardiac arrest secondary to ventricular fibrillation (n=1, 1%), and stroke (n=1, 1%). The majority of maternal events (13/14, 93%) occurred in women with no previous diagnosis of coronary disease.ConclusionsWomen with paediatric-onset coronary artery anomalies have a 14% risk of adverse cardiovascular events in pregnancy, indicating the need for careful assessment and close follow-up. Prospective, multicentre studies are required to better define risk and predictors of complications during pregnancy.

Hydrocephalus resulting from superior vena cava thrombosis in an infant

1975 ◽  
Vol 42 (5) ◽  
pp. 597-601 ◽  
Author(s):  
Floyd L. Haar ◽  
Carole A. Miller
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Venous Pressure ◽  
Vena Cava ◽  
Normal Pressure ◽  
Dural Sinus ◽  
Communicating Hydrocephalus ◽  
Content Type ◽  
Venous Structure ◽  
Vena Cava Thrombosis

✓ The authors report an unusual case of superior vena cava thrombosis in an infant who subsequently developed communicating hydrocephalus; they also review previously reported cases of dural sinus hypertension, and separate them into two groups. Patients in the first group develop hydrocephalus and those in the second develop a pseudotumor-like syndrome. The former patients tend to have generalized increase in intracranial venous pressure while the latter have a normal pressure in some major intracranial venous structure(s). The absence of venous cushioning of the choroid plexus pulse wave is proposed as the cause of ventricular enlargement in the former group. In addition, patients in the large-ventricle group were younger than patients in the small-ventricle group.

Sign in / Sign up

Export Citation Format

Share Document