Anomalous origin of culprit coronary arteries in acute coronary syndromes

Tyczyński, Paweł; Kukuła, Krzysztof; Pietrasik, Arkadiusz; Bochenek, Tomasz; Dębski, Artur; Oleksiak, Anna; Marona, Miłosz; Lelek, Michał; Stępińska, Janina; Witkowski, Adam

doi:10.5603/cj.a2017.0142

Cited by 8 publications

(12 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Anomalous origin of right coronary artery from the left coronary sinus and the origin of left circumflex artery from the right coronary sinus are the most common coronary anomalies . Nonetheless, a few patients present with atherosclerotic-related disease, and they may be asymptomatic . In a study of more than 126 000 individuals, anomalous origin of a coronary artery was identified in less than 1%, and none of these patients presented with an acute coronary syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…1 Nonetheless, a few patients present with atherosclerotic-related disease, and they may be asymptomatic. 4,5 In a study of more than 126 000 individuals, 5 anomalous origin of a coronary artery was identified in less than 1%, and none of these patients presented with an acute coronary syndrome. Anomalous coronary arteries may trigger intermittent ischemia to which the mechanism is complex and not fully understood.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A 71-Year-Old Man With Inferior ST-Segment Elevation

Alkhalil

Owens

2019

JAMA Cardiol

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A 71-Year-Old Man With Inferior ST-Segment Elevation

Alkhalil

Owens

2019

JAMA Cardiol

View full text Add to dashboard Cite

“…Unless patients have presented in early life with angina, the discovery of the CAA in patients with acute coronary syndrome is incidental ( 2 ). To date, there is only 1 other reported case of a patient presenting with 1) an anterior ST-segment elevation myocardial infarction (STEMI) from 2) a culprit lesion in the LAD that is anomalous with the 3) left coronary artery arising from the right coronary sinus ( 6 ). Performing PCI in patients with CAAs is challenging and carries an increased risk of ostial dissection ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

Anomalous Left Coronary Artery Arising From Right Coronary Sinus in the Setting of Anterior STEMI

Rajani

ElMaghawry

Mittal³

et al. 2021

JACC: Case Reports

View full text Add to dashboard Cite

We present the case of a 55-year-old man who had a diagnosis of an acute anterior ST-segment elevation myocardial infarction. Emergency angiography demonstrated that both coronary systems originated from the right coronary sinus with a culprit proximal left anterior descending artery lesion, which was stented. This is a rare presentation, with only 1 similar case found in published reports. ( Level of Difficulty: Intermediate. )

show abstract

“…1B). The left anterior descending coronary artery (LAD) supplies segments 1,2,7,8,13,14, and 17, the right coronary artery (RCA) supplies segments 3, 4, 9, 10, and 15, while the left circumflex coronary artery (LCx) supplies segments 5, 6, 11, 12, and 16 [11]. However, coronary arteries may be anomalous and their anatomy varies from patient to patient, creating a limitation of the AHA model [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Ischemic and non-ischemic patterns of late gadolinium enhancement in heart failure with reduced ejection fraction

et al. 2021

View full text Add to dashboard Cite

Background: Late gadolinium enhancement (LGE) by cardiac magnetic resonance (CMR) may reveal myocardial fibrosis which is associated with adverse clinical outcomes in patients undergoing implantable cardioverter-defibrillator (ICD) placement. At the same time, transmural LGE in the posterolateral wall is related to nonresponse to conventional cardiac resynchronization therapy (CRT). Herein, the aim was to assess the presence and determinants of LGE in CMR in heart failure (HF) with reduced ejection fraction. Methods: 67 patients were included (17.9% female, aged 45 [29-60] years), who underwentLGE-CMR and had left ventricular ejection fraction (LVEF) as determined by echocardiography. Results:In HF patients with LVEF ≤ 35% (n = 29), ischemic and non-ischemic patterns ofLGE were observed in 51.7% and 34.5% of patients, respectively. In controls (n = 38), these patterns were noted in 23.7% and 42.1% of patients, respectively. HF patients with LVEF ≤ 35% and transmural LGE in the posterolateral wall (31.0%) were characterized by older age, coronary artery disease (CAD) and previous myocardial infarction (MI) (61 ± 6 vs. 49 ± 16 years, p = 0.008, 100% vs. 40%, p = 0.003 and 78% vs. 25%, p = 0.014, respectively). In patients with LVEF ≤ 35%, LGE of any type, diagnosed in 86.2% of patients, was associated with CAD (68% vs. 0%, p = 0.02), while only trends were observed for its association with older age and previous MI (p = 0.08 and p = 0.12, respectively). Conclusions: Among HF patients with LVEF ≤ 35%, clinical factors including older age, CAD, and previous MI are associated with transmural LGE in the posterolateral wall, while CAD is associated with LGE. This data may have potential implications for planning ICD and CRT placement procedures. Key words: heart failure, late gadolinium enhancement, ischemic, cardiac magnetic resonance, transmural late gadolinium enhancement, cardiac resynchronization therapy, implantable cardioverter-defibrillator CONCLUSIONS Among HF patients with LVEF of 35% or less, clinical factors, including older age, CAD, and previous MI are associated with transmural LGE in the posterolateral wall, while CAD is associated with LGE. This data may have potential implications for planning ICD and CRT placement procedures.

show abstract

Anomalous origin of culprit coronary arteries in acute coronary syndromes

Abstract: The most frequently encountered AOCCA is LCx branching-off from RCA. AOCCA may either be difficult to cannulate and PCI aborted even in STEMI, or missed, especially when the intermediate branch from LCA is mimicking proper LCx.

Cited by 8 publications

References 10 publications

A 71-Year-Old Man With Inferior ST-Segment Elevation

A 71-Year-Old Man With Inferior ST-Segment Elevation

Anomalous Left Coronary Artery Arising From Right Coronary Sinus in the Setting of Anterior STEMI

Ischemic and non-ischemic patterns of late gadolinium enhancement in heart failure with reduced ejection fraction

Contact Info

Product

Resources

About