Anomalous origin of the left coronary artery from the right sinus of Valsalva in a 62-year-old woman with unstable angina pectoris: A case report

Vincelj, Josip; Todorović, Nikola; Marušić, Petar; Pukšić, Silva

doi:10.1016/j.ijcard.2008.11.182

Cited by 21 publications

(15 citation statements)

References 7 publications

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“…2 Anomalous origin of the LMCA from the right sinus of Valsalva is rather rare (reported prevalence, 0.017%-0.03%) 3 and is often associated with sudden cardiac death during exercise. The LMCA forms an acute angle at its origin, and this can compromise its lumen and blood flow as the LMCA follows the contour of the aorta to the left and posterior.…”

Section: Discussionmentioning

confidence: 99%

“…However, the anomaly is not always associated with angina pectoris; rather, the presence of angina pectoris varies in accordance with the relationship between the anomalous LMCA, the aorta, and the PA. An interarterial course of the LMCA-between the aortic root and the PA trunk-correlates with a higher incidence of angina, syncope, and sudden death. 3,5 Other anatomic variants for the course of the anomalous LMCA-including retro-aortic, right ventricular free-wall, and septal courses, and a course along the floor of the right ventricle-are considered benign. 3,6 In reviewing the medical literature, we found rare cases of anomalous origin of the LMCA from the right coronary cusp.…”

Section: Discussionmentioning

confidence: 99%

“…3,5 Other anatomic variants for the course of the anomalous LMCA-including retro-aortic, right ventricular free-wall, and septal courses, and a course along the floor of the right ventricle-are considered benign. 3,6 In reviewing the medical literature, we found rare cases of anomalous origin of the LMCA from the right coronary cusp. [3][4][5][6][7][8] Most reports concern the anomalous origin of the right coronary artery.…”

Section: Discussionmentioning

confidence: 99%

“…3,6 In reviewing the medical literature, we found rare cases of anomalous origin of the LMCA from the right coronary cusp. [3][4][5][6][7][8] Most reports concern the anomalous origin of the right coronary artery. To the best of our knowledge, no reported case is similar to ours in regard to clinical presentation and the presence of an unusually long intramural course of the LMCA between the aortic root and the PA trunk.…”

Section: Discussionmentioning

confidence: 99%

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Sudden Cardiac Death Associated with Anomalous Origin of the Left Main Coronary Artery from the Right Sinus, with an Intramural Course

Chang¹,

Hsieh²,

Chao³

et al. 2015

Texas Heart Institute Journal

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C ongenital anomalies of coronary arteries are rare, insofar as they are seen upon coronary angiography at a rate of approximately 1%.1 Anomalous origin of the left main coronary artery (LMCA) with subsequent intramural coursing between the ascending aorta and the main pulmonary artery (PA) is certainly even rarer.2 In young people engaged in strenuous exercise, this condition commonly results in myocardial ischemia, ventricular arrhythmia, and sudden cardiac death. We report such a case in which the result was favorable. Case ReportIn March 2011, an 18-year-old woman suddenly lost consciousness and collapsed upon completion of a 10-km run at her university's annual campus marathon. She had not been trained for running in accordance with any protocol, and this was her first time to expend such a level of effort. She had not experienced any symptoms before the event.In our emergency department, a 15-to 20-min course of cardiopulmonary resuscitation and electrical shock for ventricular fibrillation (Fig. 1A) enabled a return of spontaneous circulation (ROSC), and the patient was admitted to our medical intensive care unit (MICU).In the MICU, she was unconscious and her systemic pressure remained low (~80/50 mmHg), despite a high intravenous dose of an inotropic agent. Her jugular venous pressure was elevated, and her body temperature was 36 °C. A 12-lead electrocardiogram (ECG) obtained 20 minutes after ROSC showed sinus tachycardia with nonspecific ST-T changes and no prolonged QTc interval (QTc, 446 ms) (Fig. 1B). Her initial arterial blood gas analysis showed hypoxia with respiratory and metabolic acidosis. The chest radiograph taken immediately after admission to the MICU showed a normal heart size with bilateral pulmonary edema, similar to a pattern of acute respiratory distress syndrome. A transthoracic echocardiogram (TTE) taken 2 hours after her admission to the MICU revealed a normal left ventricular (LV) chamber size with diffuse hypokinesia and an LV ejection fraction (LVEF) of approximately 0.30. No pericardial effusion was found. The initial complete blood counts, the blood chemistry results, and the toxicology screen were all normal. An intra-aortic balloon pump (IABP)-inserted about 3 hours after admission to the MICU-subsequently assisted, over the course of 4 days, with extracorporeal membrane oxygenation (ECMO) for cardiogenic shock.The patient's general condition improved substantially after therapeutic hypothermia, and she awoke on the 3rd day of hospitalization. On the 4th and 5th days, she was successfully weaned from the ECMO, the IABP, and the mechanical ventilator.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Sudden Cardiac Death Associated with Anomalous Origin of the Left Main Coronary Artery from the Right Sinus, with an Intramural Course

Chang¹,

Hsieh²,

Chao³

et al. 2015

Texas Heart Institute Journal

View full text Add to dashboard Cite

show abstract

“…The incidence of coronary artery anomalies has been reported between 0.6% to 1.3% in angiographic series and 0.3% in autopsy series [4]. The inter-arterial course of the LCA, between the aortic root and the pulmonary artery trunk, correlates with a higher incidence of angina, syncope and sudden death [5].…”

Section: Discussionmentioning

confidence: 99%

Right Coronary Artery Originating From the Left Coronary Sinus: A Rare Coronary Artery Anomaly

Conkbayır

2014

Russ J Cardiol

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Anomalous origin of the right coronary artery (RCA) from the left coronary sinus is a rare congenital anomaly. Here, we report a case of a 54-year-old symptomatic woman who was admitted with a history of unstable angina pectoris, hypertension, coronary arteriosclerosis, diabetes mellitus, hypercholesterolemia and previous coronary bypass operation (CABG). Coronary angiography was performed and a right coronary artery was discovered, which was seen to arise from the left coronary sinus. Аномальное отхождение правой коронарной артерии (RCA) из левого коро-нарного синуса -редкая врожденная аномалия. Здесь, мы сообщаем о слу-чае 54-летней женщины, которая была госпитализирована с нестабильной стенокардией, гипертонией, коронарным атеросклерозом, сахарным диабе-том, гиперхолестеринемией и предыдущими операциями аортокоронарного шунтирования (АКШ) в анамнезе. При коронарной ангиографии правой коро-нарной артерии был обнаружено, что она восходит из левого коронарного синуса. RussРоссийский кардиологический журнал 2014, 1 (105), Англ.: 56-57Ключевые слова: правая коронарнаяй аномалия, врожденный.

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Ectopic origin and communicating branch of left anterior descending artery arising from the conus artery: a rare coronary anomaly

Shan

Ming

Zhao

2019

Herz

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Anomalous origin of the left coronary artery from the right sinus of Valsalva in a 62-year-old woman with unstable angina pectoris: A case report

Cited by 21 publications

References 7 publications

Sudden Cardiac Death Associated with Anomalous Origin of the Left Main Coronary Artery from the Right Sinus, with an Intramural Course

Sudden Cardiac Death Associated with Anomalous Origin of the Left Main Coronary Artery from the Right Sinus, with an Intramural Course

Right Coronary Artery Originating From the Left Coronary Sinus: A Rare Coronary Artery Anomaly

Ectopic origin and communicating branch of left anterior descending artery arising from the conus artery: a rare coronary anomaly

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