Haemodynamic significance of an anomalous right coronary with inter-arterial course assessed with intracoronary pressure measurements during dobutamine challenge. | LitMetric
Autopsy studies have associated congenital coronary anomalies with the risk of sudden cardiac death. However, not all patients with anomalous coronary arteries die suddenly. A means of assessing the potential for ischaemia and thus predicting the risk of sudden death in these patients may be necessary for directing treatment. We present the case of a patient with an anomalous right coronary artery originating from the aortic wall above the left sinus of Valsalva, with an anterior inter-arterial course. The haemodynamic significance of this anomaly was assessed using intracoronary pressure-wire measurements at rest and during dobutamine stress. This technique could be a valid means for assessing stress-induced ischaemia and, therefore, by inference, the risk of sudden cardiac death in these patients.
Pulmonary venous developmental anomalies have historically been evaluated using echocardiography and catheter-based angiography. In recent years, however, multidetector CT angiography (MDCTA) and MR angiography have become increasingly important tools for detailed characterization of these anomalies. This case report provides an in-depth review of the radiologic findings in a 15-year-old patient diagnosed with the supracardiac type of Total Anomalous Pulmonary Venous Connection (TAPVC).
An anomalous origin of the right coronary artery from the opposite sinus (R- ACAOS) with interarterial course is a very rare congenital anomaly with an increased risk of sudden cardiac death. A 29-year-old woman was admitted for exertional angina pectoris. A coronary computed tomography angiography with 3D multiplanar reconstruction revealed an R-ACAOS running between the aorta and pulmonary artery with high anatomical features and no ischemia-induced at the stress test.
Double-chambered right ventricle (DCRV) is a congenital heart disease. Most cases of DCRV are complicated by another congenital cardiac anomaly. Mostly, a ventricular septal defect (VSD) is the usual comorbidity.
Coronary artery anomalies (CAAs) are rare and challenging, with increased diagnoses due to advanced cardiovascular imaging, even in low-income countries where diagnostic and therapeutic approaches can be difficult. This case report details a 65-year-old Black male patient with a history of hypertension and smoking who presented with a myocardial infarction. Despite no significant abnormalities apart from the infarction, invasive coronary angiography revealed a dominant right coronary artery (RCA) and an anomalous left main coronary artery (LMCA) originating from the right coronary sinus, bifurcating into the left anterior descending artery and circumflex artery.
