scholarly journals Type X dual left anterior descending (LAD) artery masquerading as type 1 LAD — a case report

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Anish Bhargav ◽  
Parminder S. Otaal ◽  
Manphool K. Singhal
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Interventricular Septum ◽  
Microvascular Dysfunction ◽  
Circumflex Artery ◽  
Bare Area ◽  
Stenotic Lesion ◽  
Left Circumflex Artery ◽  
New Variant

Abstract Background Dual left anterior descending (LAD) coronary artery is a rare congenital anomaly. To date, eleven variants of dual LAD have been described with three published reports of type X dual LAD. Here, we describe a new variant of type X dual LAD with a short LAD artery masquerading as type 1 LAD. Case presentation A 42-year hypertensive female presented with recent onset angina with a treadmill test positive for inducible ischemia. Coronary angiography showed a normal right coronary artery (RCA). The left main coronary artery (LMCA) originated from the left sinus of Valsalva (SOV), giving rise to a LAD and the left circumflex artery (LCX). Appearing a normal angiogram with type 1 LAD based on its length, the presence of a large bare area in LAD territory (especially at the apex) and lack of septal branches prompted a search for an additional vessel. Right SOV injection showed a vessel originating separately from RCA, which was confirmed to be a long LAD on selective injection, with a pre-pulmonic course and giving rise to septal branches exclusively before wrapping around the apex. Computed tomography coronary angiography (CTCA) confirmed the pre-pulmonic course of long LAD, defined its entry to the distal interventricular septum to the right of short LAD, and ruled out other coronary artery anomalies. In the absence of a stenotic lesion in the epicardial coronaries, angina in our case was presumed to be due to microvascular dysfunction. She was discharged on beta-blocker therapy for co-existing hypertension and is asymptomatic on follow-up at one year. Conclusions A short LAD artery of type X Dual LAD could be potentially misdiagnosed as type 1 LAD based on its length. However, an active search for a long LAD could properly diagnose the case as a variant of type X dual LAD, which has important clinical implications. Its awareness is critical for cardiologists and cardiac surgeons to correctly interpret the coronary angiogram and plan proper management.

scholarly journals Anomalous Origin of a Stenosed Left Circumflex Coronary Artery in a Patient Presenting with Unstable Angina: A Case Report

2016 ◽  
Vol 54 (4) ◽  
pp. 247-249
Author(s):  
Hossein Vakili ◽  
Isa Khaheshi ◽  
Mehdi Memaryan ◽  
Mohammadreza Naderian
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Unstable Angina ◽  
Coronary Intervention ◽  
Sinus Of Valsalva ◽  
Circumflex Coronary Artery ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Diagnostic Coronary Angiography

Abstract 73 year-old man presented to our emergency department with complaint of retrosternal chest pain since 2 day and admitted with diagnosis of unstable angina. He underwent diagnostic coronary angiography in which left circumflex artery (LCX) was not visualized during injection of the left coronary artery; indeed, it was originated, with common origin with RCA, from right coronary sinus of Valsalva. This case report is one of the uncommon cases with aberrant coronary arteries who presented with unstable angina. Moreover, coronary angiography with following coronary angioplasty was performed for him in a challenging course and angle for coronary intervention.

scholarly journals Relationship between neutrophils to HDL-C ratio and severity of coronary stenosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tuli Kou ◽  
Haorou Luo ◽  
Lixue Yin
Keyword(s):  
Regression Analysis ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Stenosis ◽  
Independent Predictor ◽  
Control Group ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Markers Of Inflammation ◽  
Luminal Stenosis

Abstract Background Lipid and inflammatory molecules play a key role in the development of inflammation. Neutrophil counts are used as markers of inflammation duration, and HDL-C is used as an anti-atherosclerosis component. However, few studies have been found to integrate these two indicators to explore coronary stenosis. We suggested that neutrophil count as a marker of inflammation persistence and HDL-C as an anti-atherosclerotic component should be integrated into a single biomarker NHR to explore its correlation with CAD degree and predict the severity of coronary stenosis among CAD patients. Methods We examined 404 eligible patients who underwent coronary angiography. Based on the results of coronary angiography, patients in CAD+ group (n = 155) were defined as those having angiographic coronary stenosis of at least 50% lumen reduction in at least one major coronary artery (including left anterior descending artery, left circumflex artery, left main coronary artery, right coronary artery). Patients with luminal stenosis but no more than 50% were defined as CAD− group (n = 49), and patients without luminal stenosis (n = 200) were regarded as control group. The relationship between various serum markers and the severity of coronary stenosis was examined by Spearman correlation analysis. Logistic regression analysis was performed to identify the influencing factors of the severity of coronary artery disease. Results The modified Gensini score was positively correlated with neutrophil HDL-C ratio and negatively correlated with albumin and HDL-C. Multiple regression analysis showed that neutrophil HDL-C ratio were significantly associated with CAD. Neutrophil HDL-C ratio is an independent predictor of CAD. The ROC analysis provided a cut-off value of 1.51 for neutrophil HDL-C ratio to predict CAD with 94.8% sensitivity and 0.024 Yoden index, and area under the ROC curve of 0.617 (95% CI 0.560–0.675, P < 0.001). Conclusion Neutrophil HDL-C ratio is not only closely related to coronary artery stenosis, but also an independent predictor of severe coronary stenosis.

Abstract 141: A Case of Kawasaki Disease with Re-dilatation of a Coronary Artery Aneurysm after Regression

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Kensuke Oka ◽  
Takaomi Minami ◽  
Tatsuya Anzai ◽  
Sadahiro Furui ◽  
Akiko Yokomizo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Angiography ◽  
Artery Aneurysm ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Ct ◽  
History Of ◽  
The Right

Background: In patients with Kawasaki disease (KD), re-dilatation of coronary artery lesions (CAL) after regression is very rare. Here we report a case of KD with CAL re-dilatation after regression. Case report: A 15-year-old boy was diagnosed with KD at 1 year of age and was treated with intravenous immunoglobulin (IVIG, 400 mg/kg х 5 days). On day 14, echocardiography revealed CAL on the right coronary artery (RCA) and left coronary artery (LCA). Coronary arteriographic findings were as follows: segment 1, 3 mm in diameter; segment 6, 5 mm in diameter. He was prescribed aspirin, ticlopidine, and warfarin for 3 years. When he was 3 years old, coronary angiography showed complete CAL regression. His medications were discontinued and he underwent routine follow-up by echocardiography on which the CAL were not seen. At 14 years of age, coronary CT revealed re-dilatation of the LCA. Coronary angiography showed the same findings: 7 mm in diameter at the bifurcation between the LAD and the left circumflex artery, while the other regions were intact. He restarted aspirin and warfarin. The mechanism of CAL re-dilatation remains unclear; however, it is very important to follow patients carefully and routinely using echocardiography and/or coronary computed tomography, especially in cases with a history of CAL.

Coronary Angiographic Finding of Thrombus in the Left Atrial Appendage

1996 ◽  
Vol 37 (3P2) ◽  
pp. 749-753 ◽  
Author(s):  
I. Sakamoto ◽  
K. Hayashi ◽  
N. Matsunaga ◽  
Y. Ogawa ◽  
Y. Matsuoka ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Left Atrial ◽  
Heart Surgery ◽  
Left Atrial Appendage ◽  
Open Heart Surgery ◽  
Atrial Appendage ◽  
Open Heart ◽  
Circumflex Artery ◽  
Left Circumflex Artery

Purpose: The value of coronary angiography in the diagnosis of thrombus in the left atrial appendage (LAA) was retrospectively analyzed. Material and Methods: The study covers 34 patients in whom coronary angiography showed coronary neovascularity in LAA with coronary artery-left atrial fistula indicating LAA thrombus. All 34 patients underwent transthoracic echocardiography within one week of coronary angiography. Open-heart surgery was undertaken 2–31 months after angiography in 28 patients. Results: Coronary neovascularity and coronary artery-left atrial fistula arose from the left circumflex artery in 28 patients, and from the left circumflex artery and the right coronary artery in the remaining 6 patients. By echocardiography, LAA thrombus was detected in only one of the 34 patients. In 18 of the 28 patients who underwent open-heart surgery, LAA thrombus was found at surgery to have resolved. Conclusion: Coronary angiography is useful in the diagnosis of LAA thrombus, and coronary neovascularity and fistula formation may indicate that the thrombus can spontaneously resolve.

Evaluation of Tc-99m Tetrofosmin Scan for Coronary Artery Disease Diagnosis

2002 ◽  
Vol 10 (3) ◽  
pp. 244-247
Author(s):  
Elie Chammas ◽  
Ahmad Yatim ◽  
Chadi Hage ◽  
Kozhaya Sokhn ◽  
Walid Tarcha ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Myocardial Perfusion ◽  
Sensitivity And Specificity ◽  
Right Coronary Artery ◽  
Exercise Stress ◽  
Stress Tests ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
The Right

Detection of myocardial perfusion abnormalities using Tc-99m tetrofosmin was evaluated for sensitivity and specificity compared to coronary angiography. Between January 1996 and January 1998, exercise stress tests and myocardial scintigraphy were performed in 58 patients, followed by coronary angiography within 2 months. There were 48 males and 10 females, aged 33 to 72 years (mean, 57 years). The sensitivity and specificity of exercise stress tests were 64% and 68%, respectively, while the sensitivity and specificity of Tc-99m tetrofosmin scans were 88% and 75%, respectively, compared to angiography. For Tc-99m tetrofosmin scans, the sensitivity was 78% for the left anterior descending artery, 66% for the left circumflex artery, and 76% for the right coronary artery; specificity was 74% for the left anterior descending artery, 90% for the left circumflex artery, and 75% for the right coronary artery. It was concluded that Tc-99m tetrofosmin allowed high-quality myocardial perfusion imaging with results comparable to those obtained using thallium-201 chloride.

Hypoplastic Left Circumflex Coronary Artery: Imaging Findings with Coronary Computed Tomography Angiography - A Case Report

2019 ◽  
Vol 15 (4) ◽  
pp. 427-429
Author(s):  
Asli Tanrivermis Sayit ◽  
Cetin Celenk
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Computed Tomography Angiography ◽  
Coronary Artery Imaging ◽  
Circumflex Coronary Artery ◽  
Circumflex Artery ◽  
Coronary Computed Tomography ◽  
True Incidence ◽  
Left Circumflex Artery ◽  
Artery Disease

<P>Background: Hypoplastic coronary artery disease is a rare congenital coronary artery anomaly. It is often detected incidentally, and its true incidence in the general population is not known. </P><P> Discussion: Symptoms of HCAD are syncope, palpitations, dyspnea, and chest pain. Also, arrhythmia and myocardial infarction can be seen; these can cause sudden death, especially in athletes and young people. Diagnosis is often made at autopsy. Conclusion: Here, we present the case of a 39-year-old male with isolated hypoplasia of the left circumflex artery detected by coronary Computed Tomography (CT) angiography who complained of palpitation.</P>

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