Anomalous origin of the right coronary artery from the pulmonary artery diagnosed in an adult: A case report

Nakabayashi, Keisuke; Okada, Hisayuki; Iwanami, Yuji; Sugiura, Ryo; Oka, Takahiro

doi:10.1016/j.jccase.2014.06.001

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Therefore, BWG is the most appropriate diagnosis, and CAA may be associated with high blood flow between the RCA and LCA, as well as steal phenomenon. The existence of a left coronary artery aneurysm, an asymptomatic course, and normal heart function in an adolescent distinguish our case of BWGS from the previous published reports [ 1 , 4 , 6 , 8 , 9 , 11 , 13 ]. In this case, the patient was advised to undergo surgical management of BWGS in an advanced setting abroad.…”

Section: Discussionsupporting

confidence: 42%

“…During fetal life, antegrade flow from the pulmonary artery to the coronary artery occurs because of high pulmonary artery pressure, allowing for satisfactory myocardial perfusion from the pulmonary artery through the anomalous coronary artery [ 7–10 ]. However, after birth, the pulmonary artery contains desaturated blood at a pressure that rapidly falls below systemic pressure [ 4 , 7 , 9 ]. Therefore, the left ventricle, with its huge demand for oxygen, is perfused with desaturated blood at low pressure [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Adults might have no symptoms, but more frequently, they can have a variety of symptoms, including syncope, chest pain, and sudden death [ 2 , 4 , 5 ]. The final stage in late adulthood, involves an overloaded collateral artery that repeatedly experiences ischemia due to the steal phenomenon from the RCA to the LCA and pulmonary artery [ 9 ]. BWGS can be diagnosed through the use of computed tomography (CT) of the chest, coronary angiography, and echocardiography [ 3 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

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Bland White Garland syndrome with aneurysm and collaterals of coronary arteries in an Afghan girl: a case report.

Aslamzai,

Sharifi,

Ekram

2024

Oxford Medical Case Reports

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Bland White Garland Syndrome is a very rare congenital heart defect in which the left coronary artery arises abnormally from the pulmonary artery. We present an extremely rare case of Bland White Garland Syndrome with an aneurysm of the left coronary artery in a 14-year-old Afghan girl. The patient was asymptomatic throughout her life except for one attack of exertional chest discomfort. The diagnoses of these anomalies were established by electrocardiography, echocardiography, coronary angiography, and computed tomography of the chest. During her hospital stay and on discharge, she had a stable condition and was referred for surgical management in an advanced setting abroad. Anomalous origin of the left coronary artery from the pulmonary artery may coexist with an aneurysm of the left coronary artery and not exhibit symptoms until adolescence.

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Section: Discussionsupporting

confidence: 42%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Bland White Garland syndrome with aneurysm and collaterals of coronary arteries in an Afghan girl: a case report.

Aslamzai,

Sharifi,

Ekram

2024

Oxford Medical Case Reports

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“…Patients may complain of ischemic chest pain and are found to have the rare anomaly by coronary imaging examinations for the screening of coronary artery diseases. Noninvasive imaging examinations including TTE, CCTA, and scintigraphy are useful for detecting and diagnosing anatomical and physiological abnormalities in ARCAPA [6]. In the present case of long-year symptomatic ARCAPA, we recognized the abnormally developed intracoronary collateral perfusion by transthoracic Doppler echocardiography and reached the definite diagnosis of ARCAPA by CCTA.…”

Section: Discussionmentioning

confidence: 56%

Anatomical and physiological assessment of a symptomatic anomalous origin of the right coronary artery from the pulmonary artery by noninvasive imaging examinations

Nishino¹,

Watanabe²,

Komatsu³

et al. 2020

Journal of Cardiology Cases

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Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is an extremely rare congenital disease with an estimated prevalence of 0.002% [1]. Recent advancement of diagnostic imaging modality has increased the diagnostic yield for congenital cardiovascular malformations, and the number of the case reports of ARCAPA has increased since the first case report described by Brooks in 1885 [2]. However, it is still difficult to diagnose this uncommon congenital disease because of its generally asymptomatic nature, and most of the cases of ARCAPA are incidentally or unexpectedly diagnosed in the diagnostic process of other cardiac/noncardiac diseases. We present a long-year symptomatic ARCAPA, anatomically and physiologically diagnosed by using transthoracic echocardiography (TTE) and coronary computed tomography angiography (CCTA).

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“…This results in a “steal phenomenon” causing chronic myocardial ischemia and symptoms related to chronic left-to-right shunt. This may also result in ventricular dilatation and dysfunction with the severity depending on the shunt size, the number of collaterals, the territory at risk, and the overall myocardial oxygen demands [11, 12].…”

Section: Discussionmentioning

confidence: 99%

Anomalous Origin of a Right Coronary Artery from Pulmonary Artery

Rawala

Naqvi

Farhan

et al. 2018

Case Reports in Cardiology

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Congenital defects of the coronary arteries are noted in 0.2–1.4% of the general population. The first case of an anomalous origin of right coronary artery from pulmonary artery (ARCAPA) was described by Brooks in 1885. ARCAPA has an overall incidence of 0.002% in the general population. Most of the cases are asymptomatic; however, it can lead to serious complications such as heart failure, ischemia, and sudden death. A 57-year-old man presented to the cardiologist's office with complaints of shortness of breath and fatigue. The patient also had a previous history of coronary stents and heart failure. Initially, he was evaluated with a stress test which was reported as abnormal. The patient then underwent an invasive coronary angiography that revealed anomalous origin of the right coronary artery (RCA) and multivessel disease. Cardiothoracic surgery evaluated the patient and coronary artery bypass graft was performed. During the surgery, the anomalous origin of RCA from the pulmonary artery was identified and was successfully corrected by reimplanting the RCA into the ascending aorta. The anomalous origin of RCA is a rare yet life-threatening condition. The RCA due to its location of origin from the pulmonary artery tends to be a low-pressure vessel with a very thin and fragile wall. It also serves as a retrograde venous conduit from the left coronary circulation into the pulmonary artery. This connection results in a left-to-right shunt that explains the increase in oxygen saturation in the pulmonary artery and the high cardiac output which is normally seen in these cases. The clinical presentation can vary from coronary ischemia to heart failure or sudden death. Therefore, surgical correction is recommended even in asymptomatic patients. We present a case of an anomalous origin of RCA from the pulmonary artery which, unlike the origin of left coronary from pulmonary artery, is very rare. Patients with this condition should have early correction even if they are asymptomatic in order to prevent long-term complications.

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Anomalous origin of the right coronary artery from the pulmonary artery diagnosed in an adult: A case report

Cited by 5 publications

References 7 publications

Bland White Garland syndrome with aneurysm and collaterals of coronary arteries in an Afghan girl: a case report.

Bland White Garland syndrome with aneurysm and collaterals of coronary arteries in an Afghan girl: a case report.

Anatomical and physiological assessment of a symptomatic anomalous origin of the right coronary artery from the pulmonary artery by noninvasive imaging examinations

Anomalous Origin of a Right Coronary Artery from Pulmonary Artery

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