scholarly journals Anomalous Origin of Coronary Artery from the Contralateral Aortic Sinus - Case Report

2018 ◽  
Vol 12 (2) ◽  
pp. 98-101
Author(s):  
Kajal Kumar Karmoker ◽  
Khandaker Aisha Siddika ◽  
Arif Hossain ◽  
Mohammad Adib Al Javed ◽  
Bijoy Datta
Keyword(s):  
Coronary Artery ◽  
Sudden Death ◽  
Coronary Arteries ◽  
Anomalous Origin ◽  
Complex Congenital Heart Disease ◽  
Coronary Artery Anomalies ◽  
Aortic Sinus ◽  
Diagnostic Work ◽  
Work Up ◽  
Congenital Coronary Artery Anomalies

Congenital coronary artery anomalies are rare heart defect that has been associated with myocardial ischemia and sudden death. Only 1-2% of population having variation in the origin, course or distribution of the epicardial coronary arteries. Anomalous origin of coronary arteries may be present as isolated defect or as a part of complex congenital heart disease. The clinical presentation, diagnostic work up, prognosis and treatment of these anomalies are highly variable. Most of the patients are asymptomatic but manifestation of these patients are chest pain, dyspnoea, palpitation, dizziness, ventricular fibrillation, syncope and sudden death. It is the second most common cause of sudden death in young athletes. Selective coronary angiography is the gold standard for identification of such type of anomaly. Patients of anomalous origin of coronary artery from the opposite sinus may require medical treatment, coronary angioplasty with stenting or surgical repair.University Heart Journal Vol. 12, No. 2, July 2016; 98-101

Congenital coronary artery anomalies

2019 ◽  
pp. 217-225
Author(s):  
Cristina Basso ◽  
Carla Frescura ◽  
Stefania Rizzo ◽  
Gaetano Thiene
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Provocation Test ◽  
Acute Angle ◽  
Anomalous Origin ◽  
Coronary Artery Anomalies ◽  
Aortic Sinus ◽  
Diagnostic Work ◽  
The Right ◽  
Congenital Coronary Artery Anomalies

Despite the low prevalence in the general population, congenital coronary artery anomalies (CAAs) are well recognized as a major cause of sudden cardiac death (SCD). Not all CAAs have the same prognostic impact and each of them should be discussed individually. Apart from anomalous origin of a coronary artery (CA) from the pulmonary artery, the anomalous origin from the wrong aortic sinus, either the left main CA from the right sinus or the right CA from the left sinus, are traditionally considered as the highest risk of SCD. CAAs with an inter-arterial course carry the highest risk of ischaemia, particularly during exercise. Several pathophysiological mechanisms have been postulated, including compression of the anomalous CA between the aorta and the pulmonary artery, the acute angle take-off, the proximal intra-mural aortic course, and a superimposed CA spasm. The diagnostic work-up, including ischaemia provocation test imaging tools, and current management strategies, from sport restriction to surgical intervention, are discussed.

scholarly journals Anomalous Origin of Coronary Arteries

2020 ◽  
Author(s):  
Xhevdet Krasniqi ◽  
Hajdin Çitaku
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Interventional Cardiology ◽  
Anomalous Origin ◽  
Coronary Artery Anomalies ◽  
Circumflex Artery ◽  
Artery Disease ◽  
Recent Classification ◽  
The Right ◽  
And Function

Coronary arteries supply the heart muscle with blood maintaining myocardial hemostasis and function. Coronary artery anomalies may persist after birth affecting cardiovascular system through haemodynamic impairment caused from shunting, ischaemia, especially in young children or adolescents and young adults. In patients undergoing coronary angiography the incidence of anomalous origination of the left coronary artery from right sinus is 0.15% and the right coronary artery from the left sinus is 0.92%. A recent classification of the coronary anomalies is based on anatomical considerations, recognizing three categories: anomalies of the origin and course, anomalies of the intrinsic coronary artery anatomy, and anomalies of the termination. In the setting of anomalous coronary artery from the opposite sinus, the proximal anomalous CA may run anterior to the pulmonary trunk (prepulmonic), posterior to the aorta (retroaortic), septal (subpulmonic), or between the pulmonary artery and the aorta itself (interarterial). Among them, only those with an interarterial aorta-pulmonary course are regarded as hidden conditions at risk of ischaemia and even sudden death. We presented two cases with anomalous origin of coronary arteries from opposite sinus, and two other cases with anomalous origin of left circumflex artery. The atherosclerotic coronary artery disease leads to the need of coronarography which can find out the presence of coronary artery anomalies. Anomalous origin of coronary artery that is present with atherosclerotic changes continues to exist as a challenge during treatment in interventional cardiology.

scholarly journals Myocardial bridging in the course of coronary arteries and its clinical significance

2020 ◽  
Vol 11 (6) ◽  
pp. 58-62
Author(s):  
Gunjan Rai ◽  
Soumya Khanna ◽  
Royana Singh
Keyword(s):  
Coronary Artery ◽  
Sudden Death ◽  
Coronary Arteries ◽  
Arterial Disease ◽  
Myocardial Bridging ◽  
Myocardial Bridge ◽  
Diagonal Branch ◽  
Myocardial Bridges ◽  
Coronary Arterial Disease ◽  
Congenital Coronary Artery Anomalies

Background: Sudden death in young adults in absence of any risk factor related to coronary arterial disease has been reported. It could be because of some unrecognized congenital coronary artery anomalies like myocardial bridging. The clinician should keep myocardial bridging as a differential diagnosis in cases of sudden death in young individuals having no risk factors of coronary artery diseases. Aims and Objective: The present study was conducted to know the prevalence of myocardial bridge and percentage of distribution of myocardial bridges in the course of different coronary arteries of cadaveric hearts. Material and Methods: The study was conducted in the department of Anatomy, IMS, BHU Varanasi. Total numbers of 49 formalin preserved hearts were taken for the study. The hearts were meticulously dissected to see the distribution and location of myocardial bridge. Coronary arteries with myocardial bridge were photographed and data was statistically analyzed.Out of 49 hearts, 26(53.06%) showed myocardial bridging. Total numbers of bridges were found to be 34 in number. Among the 26 myocardial bridged hearts 8 hearts (30.76%) showed double myocardial bridges and 18 hearts (69.23%) showed single myocardial bridges. In hearts with double myocardial bridging, 5 of them showed myocardial bridging in the territory of both anterior interventricular artery (AIVA) and posterior interventricular artery (PIVA) and 3 showed bridging in the territory of anterior interventricular artery and its diagonal branch. Among the18 single myocardial bridging 16 were in the course of anterior interventricular artery and two showed myocardial bridging in one of the diagonal branch of AIVA. There were 24 myocardial bridges in the course of AIVA, 16 as a part of single myocardial bridged hearts and 8 as a part of double myocardial bridged heart with the percentage of distribution were 2 (8.33%)in the proximal 1/3rd,18(75%)were in middle 1/3rd and 4(16.66%) were in distal 1/3rd. Conclusion: Due to the presence of high percentage of reported myocardial bridges in cadaveric hearts, the clinicians should always screen the young individuals and athletes having myocardial ischemia for the myocardial bridges along with other etiological factors.

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