Diagnostic Challenge in a Symptomatic Patient of Arteria Lusoria with Retro-esophageal Right Subclavian Artery and Absent Brachiocephalic Trunk

Akbar, Habibullah; Kahloon, Arslan; Kahloon, Rehan

doi:10.7759/cureus.7029

Cited by 3 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A variety of coronary artery anomalies of varying clinical significance have been reported in contemporary literature [1,2,5,6]. And some of these anomalies can result in serious clinical outcomes including but not limited to sudden cardiac death, chest pain and arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

An Extremely Rare Case of Anomalous Left Main Coronary Artery Originating From Single Right Coronary Ostium Managed Using Heart Team Approach

Akbar¹,

Akbar²,

Akbar³

et al. 2020

Cureus

Self Cite

View full text Add to dashboard Cite

Anomalies of coronary artery origin are rare, difficult to diagnose using conventional testing methods and extremely challenging to eventually manage once diagnosed. The risk of adverse outcomes increases as such patients age and develop atherosclerosis in such vessels. A comprehensive and multidisciplinary approach may be required to best manage such difficult cases. We present a case of a 65-year-old female with symptoms of chest pain concerning for unstable angina. She also complained of occasional diaphoresis and dizziness. Physical examination revealed a regular heart rhythm with no vascular bruits. An electrocardiogram (EKG) only showed normal sinus rhythm and left axis deviation. Non-invasive testing included an echocardiogram, which showed multiple wall motion abnormalities. A diagnostic cardiac catheterization via right radial artery approach was performed to delineate her coronary anatomy and rule out ischemic etiology. This led to diagnosis of anomalous coronary anatomy with an anomalous left main coronary artery from single right coronary ostium. Furthermore, it showed significant obstructive multi-vessel coronary artery disease involving distal left main artery, proximal left anterior descending artery, left circumflex and right coronary arteries. The patient had a right dominant system with absent left coronary cusp. Percutaneous vs surgical revascularization options were considered. Given high Syntax score and acceptable Society of Thoracic Surgeons (STS) risk, Heart Team approach was pursued and the patient was referred for multi-vessel surgical revascularization.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Acute plaque rupture and complete thrombosis in these arteries can result in acute coronary syndrome as well [4]. A combination of absent left coronary ostium and anomalous left main coronary artery with a single right coronary ostium is an extremely rare finding [5,6].…”

Section: Introductionmentioning

confidence: 99%

An Extremely Rare Case of Anomalous Left Main Coronary Artery Originating From Single Right Coronary Ostium Managed Using Heart Team Approach

Akbar¹,

Akbar²,

Akbar³

et al. 2020

Cureus

Self Cite

View full text Add to dashboard Cite

show abstract

“…Cocaine use can cause an ST-elevation myocardial infarction regardless of risk factors 24 . History of known congential abnormalities can be helpful 25 .…”

Section: Table Ii: Ldl-c Levels ≥70mg/dl Mg/dl (N=50)mentioning

confidence: 99%

The Effect of Atorvastatin Plus Ezetimibe Therapy Versus Atorvastatin Monotherapy on Clinical Outcome in Acute ST-Segment Elevation Myocardial Infaction(STEMI)

Abdul Mukid,

Shahabuddin,

Tazin

et al. 2023

Med. Today

View full text Add to dashboard Cite

Introduction: An acute ST-elevation myocardial infarction (STEMI) is an event in which transmural myocardial ischemia results in myocardial injury or necrosis. The current 2018 clinical definition of myocardial infarction (MI) requires the confirmation of the myocardial ischemic injury with abnormal cardiac biomarkers. Acute coronary syndrome is the leading cause of death in the world and this is a consequence of unstable plaque due to dyslipidemia, reviewing with elevated LDL cholesterol. Reduction in LDL-c repeated clinical outcomes in patients with the acute coronary syndrome. Objective: To assess the effect of atorvastatin plus ezetimibe therapy versus atorvastatin monotherapy on clinical outcome in acute ST-Segment Elevation Myocardial Infaction(STEMI). Materials and Methods: A cross-sectional study was performed at dept. of Cardiology, Parkview Medical College, Sylhet, Bangladesh from June to December 2022. A total of 50 patients were evaluated in the study, including 42 patients with acute coronary syndrome with LDL-c levels≥70mg/dL at Can Tho Central General Hospital, we divided randomly into 2 groups: group A: control LDL-c by atorvastatin 40mg and ezetimibe 10mg; group B: control LDL-c by atorvastatin 40mg monotherapy. Then we compared the effect of control LDL-c between two groups after 10 follow-up days. Results: 50 patients with acute coronary syndrome: 60.0% male and 40.0% female, the average age was 66.03 ± 12.06 years, 82.0% LDL- c levels ≥7 mg/dL. After 10 days of treatment, the target LDL-c concentration in the group treated with atorvastatin 40mg+ ezetimibe 10mg was 48.1%, in the group treated with atorvastatin 40mg was 29.9% (p<0.05). Conclusions: LDL-c ratio reaches the target in the treatment group by atorvastatin 40mg + ezetimibe 10mg was 48.1% in the treatment group with atorvastatin 40 mg was 29.9% (p<0.05). From the results of our study, we recommend the combination therapy of atorvastatin and ezetimibe control LDL-c in patients with acute coronary syndrome better than atorvastatin monotherapy, thus physicians to treat patients with the acute coronary syndrome should combine early atorvastatin with ezetimibe since hospitalization. Medicine Today 2023 Vol. 35(2): 99-104

show abstract

“…O diagnóstico pode ser obtido por exames de imagem como angiorressonância e angiotomografia (Elghoneimy et al, 2019), ou de forma eventual em pacientes assintomáticos por meio de procedimentos de cateterismo cardíaco esquerdo ou angiografia coronariana via artéria radial direita (Serra et al, 2020;Akbar;Kahloon;Kahloon, 2020). Normalmente, o tratamento está condicionado ao grau dos sintomas e os impactos na qualidade de vida do paciente, principalmente aqueles relacionados à alimentação e ao ganho de peso (Bennett et al, 2013).…”

Section: Introductionunclassified

Artéria Subclávia Direita Aberrante: Relato De Caso

Ribeiro¹,

Tannous²,

Ribeiro³

et al. 2023

Variações Anatômicas: O Avanço Da Ciência No Brasil

View full text Add to dashboard Cite

Artéria subclávia direita aberrante é a anomalia mais comum da aorta e comumente descrita como tendo sua origem após a origem da artéria subclávia esquerda. A dificuldade de deglutição é o sintoma mais comum quando a artéria aberrante causa compressão do esôfago, normalmente, pela presença de aneurisma em sua porção proximal. Estudos alertam para o risco de lesões iatrogênicas e dificuldades em concluir exames de imagem durante procedimentos pré e perioperatórios em pacientes com artéria subclávia direita aberrante. A escolha pelo melhor manejo cirúrgico ainda é debatida e a decisão de intervir deve ser individualizada. Pacientes assintomáticos podem não necessitar de nenhuma intervenção, entretanto, devem ser acompanhados para o monitoramento de possíveis alterações no diâmetro do vaso aberrante. O presente estudo relata o caso de uma paciente com artéria subclávia direita aberrante e discute aspectos anatômicos e clínicos dessa anomalia congênita.

show abstract

Diagnostic Challenge in a Symptomatic Patient of Arteria Lusoria with Retro-esophageal Right Subclavian Artery and Absent Brachiocephalic Trunk

Cited by 3 publications

References 8 publications

An Extremely Rare Case of Anomalous Left Main Coronary Artery Originating From Single Right Coronary Ostium Managed Using Heart Team Approach

An Extremely Rare Case of Anomalous Left Main Coronary Artery Originating From Single Right Coronary Ostium Managed Using Heart Team Approach

The Effect of Atorvastatin Plus Ezetimibe Therapy Versus Atorvastatin Monotherapy on Clinical Outcome in Acute ST-Segment Elevation Myocardial Infaction(STEMI)

Artéria Subclávia Direita Aberrante: Relato De Caso

Contact Info

Product

Resources

About