1
|
Ogunleye OO, Ajibola O, Cheema M, Oke B, Sperling J. Co-occurrence of Anomalous Right Coronary Artery Origin and Subaortic Membrane in an Adult Male. Cureus 2022; 14:e27110. [PMID: 36000108 PMCID: PMC9391662 DOI: 10.7759/cureus.27110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 11/05/2022] Open
|
2
|
Liu XP, Wang HJ, Gao JL, Ma GL, Xu XY, Ji LN, He RX, Qi BYE, Wang LC, Li CQ, Zhang YJ, Feng YB. Secondary coronary artery ostial lesions: Three case reports. World J Clin Cases 2022; 10:7045-7053. [PMID: 36051134 PMCID: PMC9297412 DOI: 10.12998/wjcc.v10.i20.7045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/24/2022] [Accepted: 05/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Atherosclerosis is one of the main causes of coronary artery ostial lesions seen clinically. Secondary coronary artery ostial lesions are rare, and cases reported previously were associated with syphilitic vasculitis and aortic dissection. Here, we report three rare cases of secondary coronary ostial lesions. Due to their rareness, these lesions can easily be neglected, which may lead to misdiagnosis and missed diagnosis.
CASE SUMMARY We present three patients with acute myocardial infarction and unstable angina caused by secondary coronary artery ostial lesions. In Case 1, coronary angiography (CAG) revealed 90% stenosis of the left main coronary ostium. Chest contrast computed tomography (CT) suggested thymic carcinoma invading the left main coronary ostium. Coronary artery bypass grafting and tumor resection were performed. In Case 2, echocardiography revealed a sinus of Valsalva aneurysm (SVA)-like dilatation. CAG showed a right coronary sinus giant aneurysm and complete obstruction of the right coronary artery (RCA) ostium. Aortic contrast CT confirmed these findings. The Bentall procedure was performed. In Case 3, CT CAG identified an anomalous origin of the right coronary artery (AORCA) from the left sinus of Valsalva coursing between the aorta and pulmonary trunk, causing severe RCA ostium stenosis by compression. Surgical correction of the AORCA was performed.
CONCLUSION The cases reported here suggest that we should consider other causes of coronary ostial lesions other than atherosclerosis.
Collapse
Affiliation(s)
- Xiao-Ping Liu
- Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Hai-Jun Wang
- Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Jin-Liang Gao
- Laboratory of Molecular Medicine, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Guo-Li Ma
- Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Xin-Yun Xu
- Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Li-Na Ji
- Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Rui-Xia He
- Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Ba-Ya-Er Qi
- Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Li-Cheng Wang
- Department of Radiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Chang-Qing Li
- Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Ya-Jiang Zhang
- Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Yu-Bao Feng
- Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| |
Collapse
|
3
|
Das D, Acharya D, Mahanta D, Singh S, Das T, Pramanik S. Anomalous origin of the right coronary artery from the left coronary sinus with medusa head left coronaries: Plethora of left coronary circulation with paucity of right one. Res Cardiovasc Med 2021. [DOI: 10.4103/rcm.rcm_42_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
4
|
Gupta A, Kumar V, Gupta R, Samarany S. A Case of Anomalous Origin of the Right Coronary Artery from the Left Sinus of Valsalva with a Malignant Course. Cureus 2019; 11:e5794. [PMID: 31728241 PMCID: PMC6827849 DOI: 10.7759/cureus.5794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Congenital heart disease in adults, including congenital anomalies of the coronary arteries, can be asymptomatic and diagnosed incidentally, but they can also be a cause of sudden cardiac death. The recent guidelines on the management of adults with congenital heart disease from the American Heart Association (AHA) and the American College of Cardiologists (ACC) identify that an anomalous coronary artery origin can lead to myocardial ischemia, arrhythmias, or sudden cardiac death. When the course of the coronary artery runs between the aorta and pulmonary trunk, it is described as having a "malignant course." Emergency surgical correction is required to restore the normal anatomy of the aberrant coronary artery. This report is of a 57-year-old man with a history of hypertension who had a normal electrocardiogram (ECG). A nuclear exercise stress test showed a resting and exercise ejection fraction (EF) of 56% with transient ischemic dilatation (TID) of the left ventricle. Coronary artery computed tomography angiography (CTA) identified an anomalous right coronary artery (AORCA) originating from the left sinus of Valsalva and coursing between the aorta and pulmonary trunk. TID on nuclear imaging is usually associated with left ventricular hypertrophy, microvascular disease, or multivessel macrovascular disease and has not been previously described in AORCA.
Collapse
Affiliation(s)
- Amol Gupta
- Cardiology, Heart, Vascular, and Leg Center, Bakersfield, USA
| | - Vinod Kumar
- Cardiology, Heart, Vascular, and Leg Center, Bakersfield, USA
| | - Ravi Gupta
- Cardiology, Heart, Vascular, and Leg Center, Bakersfield, USA
| | - Samir Samarany
- Cardiology, Heart, Vascular, and Leg Center, Bakersfield, USA
| |
Collapse
|