Intramural Anomalous Right Coronary Artery From the Main Pulmonary Artery

Ramani, Jaydip; Chandrasekaran, A.; Pujara, Jigisha; Thakkar, Bhavesh; Jain, Imelda; Mishra, Amit

doi:10.1177/2150135116655123

Cited by 7 publications

(11 citation statements)

References 9 publications

(16 reference statements)

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“…In 1885, Brooks identified the first 2 cases of ARCAPA postmortem [3]. Since then, just over 100 cases have been reported [4]. In 1942, Soloff et al described 4 anatomical variations for anomalous origin of the coronary arteries from the PA. Namely, anomalous origin of the left coronary artery (LCA) from the PA (ALCAPA), ARCAPA, both the LCA and the RCA originating from the PA, and an accessory coronary vessel originating from PA [5].…”

Section: Discussionmentioning

confidence: 99%

Anomalous Origin of the Right Coronary Artery from the Pulmonary Artery in a Morbidly Obese Patient Presenting with Chest Pain

2018

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Patient: Female, 58Final Diagnosis: Anomalous origin of RCA from PA with reversible myocardial ischemia of the inferior wallSymptoms: Chest pain • shortness of breathMedication: —Clinical Procedure: —Specialty: CardiologyObjective:Congenital defects/diseasesBackground:Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital anomaly with an incidence of 0.002%.Case Report:A 58-year-old African American female with a history of diabetes mellitus, hyperlipidemia, and hypertension was evaluated for shortness of breath and chest heaviness. On physical examination, she was found to be morbidly obese. Her blood pressure was 160/90 mmHg. There were no carotid bruits or jugular venous distension. Cardiac auscultation showed distant heart sounds with no audible murmurs. Lower extremity examination showed +1 edema with weak pedal pulses. ECG showed non-specific ST segment and T-wave changes. Echocardiogram demonstrated dysfunction grade I with preserved ejection fraction. An adenosine nuclear study showed an area of reversible ischemia of the inferior wall. Selective left coronary angiography showed the left coronary artery (LCA) originating from the left sinus of Valsalva. From the LCA, the left anterior descending and the left circumflex coronary arteries arose in a typical course. The right coronary artery (RCA) was visualized in a retrograde fashion via collaterals originating from the left coronary system and it drained into the pulmonary artery. On aortic root angiography, the origin of the RCA could not be determined. The patient’s surgical risk was deemed unacceptably high and she was not considered a surgical candidate. Her symptoms were controlled conservatively.Conclusions:By reporting this case, we shed some light on a rare congenital anomaly involving the coronary arteries. Variable presentations have been described for ARCAPA, however, many patients remain asymptomatic. Diagnosis can be confirmed by coronary angiography. Surgical correction is the definitive treatment.

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Section: Discussionmentioning

confidence: 99%

Anomalous Origin of the Right Coronary Artery from the Pulmonary Artery in a Morbidly Obese Patient Presenting with Chest Pain

2018

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“…Se observa la arteria coronaria derecha emergiendo de la arteria pulmonar (flecha blanca) C. Posoperatorio inmediato con reimplante de la arteria coronaria derecha en la arteria aorta (punta de flecha blanca) dominancia coronaria izquierda y la presencia de cortocircuitos de izquierda a derecha (defectos interventriculares, ductus arterioso persistente o ventana aortopulmonar). 2,11 El aumento de la presión en la arteria pulmonar se asocia con un menor robo de la circulación coronaria hacia la arteria pulmonar y, a la vez, esta condición puede brindar mayor flujo anterógrado desde la arteria pulmonar hacia la arteria coronaria derecha. 11 En nuestra paciente, la dominancia coronaria izquierda podría haber sido protectora.…”

Section: Discussionunclassified

“…2,11 El aumento de la presión en la arteria pulmonar se asocia con un menor robo de la circulación coronaria hacia la arteria pulmonar y, a la vez, esta condición puede brindar mayor flujo anterógrado desde la arteria pulmonar hacia la arteria coronaria derecha. 11 En nuestra paciente, la dominancia coronaria izquierda podría haber sido protectora. Los métodos diagnósticos dependen del período histórico de los casos reportados.…”

Section: Discussionunclassified

Origen anómalo de la arteria coronaria derecha de la arteria pulmonar en un lactante con soplo cardíaco. A propósito de un caso

2018

Arch Argent Pediatr

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Presentación de casos clínicos RESUMEN El origen anómalo de la arteria coronaria derecha de la arteria pulmonar es una entidad rara con una incidencia del 0,002 % y potencialmente grave, que puede causar muerte súbita. El diagnóstico frecuentemente es incidental, secundario a evaluaciones por soplos cardíacos a diferencia del origen anómalo de la arteria coronaria izquierda de la arteria pulmonar, reconocido por presentar isquemia miocárdica e insuficiencia cardíaca. Se reporta el caso de una niña de 6 meses evaluada por un soplo y derivada por sospecha de fístula coronaria. La evaluación mediante ecocardiograma doppler color, cateterismo cardíaco y angiotomografía mostró la presencia de una comunicación interauricular ostium secundum pequeña y origen anómalo de la arteria coronaria derecha de la arteria pulmonar. A los 11 meses, se realizó una cirugía de reimplante de la arteria coronaria derecha en la arteria aorta y el cierre de la comunicación interauricular.

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“…2,4,6,7 Some other cardiac defects associated with ARCAPA can be protective, such as stenosis at the origin of an anomalous right coronary artery, left dominant coronary circulation and left to right shunts (ventricular septal defects, patent ductus arteriosus, or aortopulmonary window). 2,11 Increased pressure in the pulmonary artery is associated with a lower steal from the coronary circulation to the pulmonary artery and also may also provide a greater anterograde flow from the pulmonary artery into the right coronary artery. 11 In our patient, the left dominant coronary circulation could have exerted a protective effect.…”

Section: Discussionmentioning

confidence: 99%

“…2,11 Increased pressure in the pulmonary artery is associated with a lower steal from the coronary circulation to the pulmonary artery and also may also provide a greater anterograde flow from the pulmonary artery into the right coronary artery. 11 In our patient, the left dominant coronary circulation could have exerted a protective effect.…”

Section: Discussionmentioning

confidence: 99%

Anomalous origin of the right coronary artery from the pulmonary artery in an infant with a heart murmur. Case report

Saavedra

Mozzi

Nápoli

et al. 2018

Arch Argent Pediatr

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The anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare entity that has an incidence of 0.002 % and can potentially cause sudden death. Unlike to the anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), usually presented with myocardial ischemia and heart failure; the diagnosis of ARCAPA is often incidental during evaluation of a heart murmur. We report a case of a 6 months old female patient referred to us with a cardiac murmur and a suspicion of coronary fistula. For a proper diagnostic assessment an echocardiogram, a computed tomography angiography and a cardiac catheterization were requested. A small ostium secundumtype atrial septal defect (ASD) and an ARCAPA were revealed. At 11 months old, the patient was scheduled for corrective cardiovascular surgery. The aim of this report is to describe a low incidence and potentially fatal disease.

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Intramural Anomalous Right Coronary Artery From the Main Pulmonary Artery

Cited by 7 publications

References 9 publications

Anomalous Origin of the Right Coronary Artery from the Pulmonary Artery in a Morbidly Obese Patient Presenting with Chest Pain

Anomalous Origin of the Right Coronary Artery from the Pulmonary Artery in a Morbidly Obese Patient Presenting with Chest Pain

Origen anómalo de la arteria coronaria derecha de la arteria pulmonar en un lactante con soplo cardíaco. A propósito de un caso

Anomalous origin of the right coronary artery from the pulmonary artery in an infant with a heart murmur. Case report

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