What is the angiography error when defining myocardial ischemia during percutaneous coronary interventions?

Background: The angiography has been used as a reference standard to define coronary artery disease (CAD), although its limitations are well-known. The significance of the myocardial fractional flow reserve (FFR) in the assessment of CAD is well established.

Objective: The aim of this study was to evaluate the accuracy of angiography when defining ischemic lesions and its correlation with FFR.

Adult patient with anomalous origin of anterior interventricular artery at main pulmonary artery.

From all congenital cardiopathies, anomalous origin of anterior interventricular artery occurs once per 300,0000 live births, reporting high mortality in the first year after birth. However, if good collateral circulation is available for the artery related to the abnormality, the patient may be kept asymptomatic until mature age. This is the report on a rare case of a 43-year-old patient who was oligosymptomatic, with normal ventricular function in this pathology presentation.