scholarly journals Anomalous Origin of Coronary Arteries

Author(s):  
Xhevdet Krasniqi ◽  
Hajdin Çitaku

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.

2018 ◽  
Vol 12 (2) ◽  
pp. 98-101
Author(s):  
Kajal Kumar Karmoker ◽  
Khandaker Aisha Siddika ◽  
Arif Hossain ◽  
Mohammad Adib Al Javed ◽  
Bijoy Datta

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


2020 ◽  
Vol 30 (10) ◽  
pp. 1510-1511
Author(s):  
Rachel Rosenthal ◽  
Hannah Obasi ◽  
Daniel D. Im

AbstractMyocarditis and coronary artery anomalies are both potentially life-threatening aetiologies of cardiac chest pain in children. We present a case of a young man presenting with non-exertional chest pain and subsequently found to have an anomalous origin of the right coronary artery from the left coronary sinus with an interarterial course in addition to a diagnosis of myocarditis. The patient subsequently was able to undergo surgical correction of his anomalous coronary to mitigate the risk of sudden cardiac death.


2014 ◽  
Vol 03 (03) ◽  
pp. 143-149
Author(s):  
Apsara M P.

Abstract Background and aims: The incidence of Coronary Artery Disease (CAD) has reached alanning proportions in India. The pathological hall mark of CAD is myocardial ischemia resulting from the atherosclerotic narrowing of coronary arteries. In this era of advanced interventions and cardiac surgery, a thorough knowledge of normal and variant anatomy of coronary arteries is of prime significance and of great use both to the clinicians and anatomists. Materials and methods: One hundred coronary angiograms of patients free of disease were studied in detail in different profiles. The data obtained was quantified according to their frequencies. The relation between the length of left main coronary artery and coronary artery dominance was statistically analyzed using the 'Chi Square test for Trend'. Results: This study highlighted some interesting findings such as the origin of Sino- atrial nodal artery from the second segment of right coronary artery in 3% of cases, double right marginal artery in 4% cases. Other variations such as Mouchet's posterior recurrent interventricular artery, origin of circumflex artery from the right coronary artery and abnormal communication between the terminal parts of right coronary artery and circumflex artery were each noticed in 1 % of cases. Conclusions: Coronary arteries and their branches are prone to variations in their course and morphology. Prior knowledge about this is important for the interpretation of coronary angiograms and surgical myocardial revascularization. The present work on normal and variant pattern of coronary arteries will help in gathering momentum to the already advancing research work in this field.


2020 ◽  
Vol 48 (4) ◽  
pp. 030006052091878
Author(s):  
Chao Feng ◽  
Liang Li ◽  
Shudong Xia

Drug-eluting stents (DESs) have a low prevalence of in-stent restenosis. However, we describe a patient with coronary artery disease with rapid progress, which might have been triggered by implantation of a DES. The patient was a 72-year-old woman who was first admitted to hospital with non-ST-segment elevated myocardial infarction and had a DES implanted after coronary angiography showed severe stenosis of the left circumflex artery. However, although she kept taking dual antiplatelet therapy, her condition deteriorated and she was admitted to hospital three more times. Angiography showed that the coronary stenosis had become more severe and was more severe not just in the stent-implanted segments, but also in other coronary arteries. Another DES and drug-eluted balloon were used. However, the stent-implanted and balloon-dilated segments became severely stenosed within 1 month. Tests for auto-immune diseases and allergies were negative. We speculate that the first DES triggered an unknown response of the coronary arteries and led to severe stenosis from the stent-implanted segment to the distal segment and other arteries.


2009 ◽  
Vol 297 (5) ◽  
pp. H1949-H1955 ◽  
Author(s):  
Thomas Wischgoll ◽  
Jenny S. Choy ◽  
Ghassan S. Kassab

The morphometry (diameters, length, and angles) of coronary arteries is related to their function. A simple, easy, and accurate image-based method to seamlessly extract the morphometry for coronary arteries is of significant value for understanding the structure-function relation. Here, the morphometry of large (≥1 mm in diameter) coronary arteries was extracted from computed tomography (CT) images using a recently validated segmentation algorithm. The coronary arteries of seven pigs were filled with Microfil, and the cast hearts were imaged with CT. The centerlines of the extracted vessels, the vessel radii, and the vessel lengths were identified for over 700 vessel segments. The extraction algorithm was based on a topological analysis of a vector field generated by normal vectors of the extracted vessel wall. The diameters, lengths, and angles of the right coronary artery, left anterior descending coronary artery, and left circumflex artery of all vessels ≥1 mm in diameter were tabulated for the respective orders. It was found that bifurcations at orders 9–11 are planar (∼90%). The relations between volume and length and area and length were also examined and found to scale as power laws. Furthermore, the bifurcation angles follow the minimum energy hypothesis but with significant scatter. Some of the applications of the semiautomated extraction of morphometric data in applications to coronary physiology and pathophysiology are highlighted.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Junji Matsuda ◽  
Takashi Ikenouchi ◽  
Giichi Nitta ◽  
Shunichi Kato ◽  
Kazuya Murata ◽  
...  

Congenital coronary artery anomalies, including anomalous origin of a coronary artery, can manifest as life-threatening conditions, such as myocardial infarction or arrhythmia, and may even lead to sudden death associated with specific congenital anatomical features. Such arteries can also develop atherosclerotic lesions. This report describes the case of a 75-year-old man who was admitted to our hospital due to exertional dyspnea. The right coronary artery was found to originate from the left coronary sinus and exhibit tight stenosis due to atherosclerosis, causing effort angina pectoris. This case highlights the fact that coronary artery anomalies can cause angina pectoris via both atherosclerotic and nonatherosclerotic effects, and successful revascularization was achieved noninvasively via percutaneous coronary angioplasty.


2019 ◽  
Vol 22 (4) ◽  
pp. E308-E309
Author(s):  
He Fan ◽  
Weng Jiakan ◽  
He Qicai ◽  
Qian Ximing ◽  
Chen Huaidong

Anomalies of the coronary arteries -- especially their abnormal origin from the pulmonary artery (ARCAPA) trunk -- are among the least common. They’re also the most dangerous of congenital heart defects with an incidence of 0.002% in the general population [Williams 2006]. The diagnosis exceedingly is difficult because anatomical abnormalities of the coronary arteries are subtle. We present a case of an anomalous origin of the right coronary artery.


2019 ◽  
Vol 30 (1) ◽  
pp. 47-49
Author(s):  
Ali A. Alakhfash ◽  
Mohamad Tagelden ◽  
Abdulrahman Almesned ◽  
Abdullah Alqwaiee

AbstractAortopulmonary window is a rare congenital heart lesion. It might be associated with other CHDs, as well as with anomalous origin of the coronary arteries. Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is the most commonly described coronary artery anomaly in association with aortopulmonary window. We are describing a premature neonate who was diagnosed to have aortopulmonary window and ARCAPA immediately after birth, and had a successful operation at the age of 4 months. This report highlights the importance of very careful assessment of the coronary arteries in patients with aortopulmonary window.


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