Patients with varying courses of single coronary artery: case series
| Autor: | Leslie Cho, Calvin C Sheng, Joanna Ghobrial |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Aorta Heart disease medicine.diagnostic_test business.industry Single coronary artery Blood flow medicine.disease Asymptomatic Magnetic resonance angiography Sudden cardiac death Interarterial course Internal medicine medicine.artery Case report Intravascular ultrasound medicine Cardiology Case Series AcademicSubjects/MED00200 medicine.symptom Instantaneous wave-free ratio Cardiology and Cardiovascular Medicine business Anomalous aortic origin of coronary artery |
| Zdroj: | European Heart Journal: Case Reports |
| ISSN: | 2514-2119 |
| DOI: | 10.1093/ehjcr/ytab314 |
| Popis: | Background Single coronary artery (SCA) is a rare congenital anomaly where blood to the heart is supplied through a common trunk. Identifying these abnormalities is important because some variants can compromise myocardial blood flow and increase risk of sudden cardiac death. Case summary We present five patients with varying Lipton Group I and Group II SCA subtypes, corroborated on multi-imaging modalities and evaluated with comprehensive non-invasive as well as invasive testing. Their clinical presentations also vary from a spectrum of asymptomatic finding to angina equivalent. The decision for definitive surgical intervention involving unroofing of the involved vessel depends largely on symptoms and evidence of myocardial ischaemia. Discussion While SCA findings are often incidental and benign, understanding the origin, branching pattern, and course of the anomalous artery has implications in prognosis and treatment. This usually involves a combination of anatomic assessment with imaging such as coronary Computed Tomography Angiography (CTA), Magnetic Resonance Angiography (MRA), and/or coronary angiography as well as functional assessment with invasive testing using tools like instantaneous wave-free ratio and intravascular ultrasound both at rest and with stress. Individualized treatment plans can then be made through a multidisciplinary approach involving adult congenital heart disease specialists and congenital cardiothoracic surgeons. |
| Databáze: | OpenAIRE |
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