Congenital absence of the right coronary artery

Yan, Gaowu; Bhetuwal, Anup; Yang, Guoqing; Fu, Quanshui; Hu, Na; Zhao, Linwei; Chen, Hong; Fan, Xiaoping; Yan, Jun; Zeng, Hao; Zhou, Qing

doi:10.1097/md.0000000000010187

Cited by 18 publications

(32 citation statements)

References 17 publications

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“…Twenty-six cases of congenital absence of the RCA have been reported in 24 articles in the last decade ( Table 1 ). 8 – 31 The mean age of patients at the time of diagnosis of congenital absence of the RCA was 53 years. Of the 26 reported cases, 14 patients were women, and 5 of them presented with acute myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

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Congenital absence of the right coronary artery with acute myocardial infarction: report of two cases and review of the literature

et al. 2020

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Congenital absence of the right coronary artery (RCA) is a rare coronary anomaly. Few cases of this condition have been reported. Congenital absence of the RCA is considered as a benign anomaly. However, in certain cases, these patients may develop life-threatening clinical complications that include acute myocardial infarction, stroke, or sudden death. We report two patients who were diagnosed with congenital absence of the RCA and presented with acute myocardial infarction. We discuss our experience in diagnosis and treatment of this disease. Congenital absence of the RCA with acute myocardial infarction is an uncommon clinical emergency. Therefore, early detection, correct diagnosis, and appropriate treatment are important.

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Section: Discussionmentioning

confidence: 99%

“…Of the 26 previously reported cases, 16 had an L-I pattern. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Therefore, the L-I pattern may be more likely to occur than the L-II pattern. Individuals with congenital absence of the RCA present with non-specific clinical features and ECG manifestations.…”

Section: Discussionmentioning

confidence: 99%

Congenital absence of the right coronary artery with acute myocardial infarction: report of two cases and review of the literature

et al. 2020

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“…In the abnormal group, the volumetric flow into the RCA was smaller. This leads to insufficient blood flow at the end of the RCA, which is unable to exchange blood with the heart in a timely manner, and this eventually leads to myocardial ischemia, such as angina [33].…”

Section: Discussionmentioning

confidence: 99%

“…If the RCA entrance is very narrow, the blood flow to the heart decreases, particularly when the heart is beating fast. Eventually, the decreased blood flow may lead to shortness of breath, angina, or other signs and symptoms of coronary artery disease [32,33].…”

Section: Discussionmentioning

confidence: 99%

Influence of malformation of right coronary artery originating from the left sinus in hemodynamic environment

Cong

Qiu

et al. 2020

BioMed Eng OnLine

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Background: The anomalous origin of the right coronary artery (RCA) from the left coronary artery sinus (AORL) is one of the abnormal origins of the coronary arteries. Most of these issues rarely have any effects on human health, but some individuals may exhibit symptoms, such as myocardial ischemia or even sudden death. Recently, researchers have investigated the AORL through clinical cases, but studies based on computational fluid dynamics (CFD) have rarely been reported. In this study, the hemodynamic changes between the normal origin of the RCA and the AORL are compared based on numerical simulation results. Methods: Realistic three-dimensional (3D) models of the 16 normal right coronary arteries and 26 abnormal origins of the RCAs were constructed, respectively. The blood flow was numerically simulated using the ANSYS software. This study used a one-way fluid-solid coupling finite element model, wherein the blood is assumed to be an incompressible Newtonian fluid, and the vessel is assumed to be made of an isotropic linear elastic material. Results: The cross-sectional area differences between the inlet of the normal group and that of the abnormal group were significant (P < 0.0001). Moreover, there were significant differences in the volumetric flow (P = 0.0001) and pressure (P = 0.0002). Positive correlation exists for the ratio of the cross-sectional area of the RCA to the inlet area of the ascending aorta (AAO), and the ratio of the inlet volumetric flow of the RCA to the volumetric flow of the AAO, in the normal (P = 0.0001, r = 0.8178) and abnormal (P = 0.0033, r = 0.6107) groups. Conclusion: This study demonstrates that the cross-sectional area of the AORL inlet may cause ischemia symptoms. The results obtained by this study may contribute to the further understanding of the clinical symptoms of the AORL based on the hemodynamics.

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“…Congenital coronary anomalies are relatively uncommon and comprise less than 2% of the general population [ 1 ]. Single coronary arteries are very rare, with an incidence on autopsy of 0.014–0.066% [ 2 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

A Rare Anatomical Variant: Congenital Absence of the Right Coronary Artery with Left Circumflex Artery Supplying the Right Coronary Artery (RCA) Territory

et al. 2021

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Patient: Female, 66-year-old Final Diagnosis: Coronary artery anomalies Symptoms: Chest discomfort • shortness of breath Medication: — Clinical Procedure: Coronary angiography Specialty: Cardiology Objective: Rare disease Background: While most coronary congenital anomalies are uncommon, comprising less than 2% of the general population, a single coronary artery is an especially rare finding within this broader category. It involves a lone vessel forming a single ostium from the aortic trunk. This vessel is then the source through which cardiac blood supply originates. Such congenital coronary artery anomalies are rare but can have clinically relevant consequences such as sudden death and other cardiac complications. Nonetheless, they are usually incidental findings and can be asymptomatic. This report discusses the case of a female patient found to have an absence of the right coronary artery, with the left circumflex supplying the right coronary artery territory. Case Report: We report a rare case of a 66-year-old woman who presented with substernal chest pain and shortness of breath. Vital signs, laboratory work-up, and resting electrocardiogram did not reveal an underlying etiology. However, an exercise stress test was positive. Left heart catheterization was performed and revealed a dominant left circumflex artery supplying the entire right coronary territory. Further imaging revealed the absence of a separate right coronary artery ostium. The patient was treated with a beta-blocker, high-intensity statin, and a nitrate. Conclusions: Single left coronary artery, especially with the absence of the right coronary artery, is particularly rare, but can have significant clinical implications. Prompt diagnosis is important but challenging considering the variable presentation of this condition. It is important to review diagnostic modalities available and the treatment for patients.

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Congenital absence of the right coronary artery

Cited by 18 publications

References 17 publications

Congenital absence of the right coronary artery with acute myocardial infarction: report of two cases and review of the literature

Congenital absence of the right coronary artery with acute myocardial infarction: report of two cases and review of the literature

Influence of malformation of right coronary artery originating from the left sinus in hemodynamic environment

A Rare Anatomical Variant: Congenital Absence of the Right Coronary Artery with Left Circumflex Artery Supplying the Right Coronary Artery (RCA) Territory

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