Importance of the Conal Branch of the Right Coronary Artery in Patients With Acute Anterior Wall Myocardial Infarction: Electrocardiographic and Angiographic Correlation

Ben‐Gal, Tuvia; Sclarovsky, Samuel; Herz, Itzhak; Strasberg, Boris; Zlotikamien, Bruria; Sulkes, Jaqueline; Birnbaum, Yochai; Wagner, Galen S.; Sagie, Alex

doi:10.1016/s0735-1097(96)00536-0

Cited by 62 publications

(36 citation statements)

References 28 publications

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“…This is consistent with what has been described by earlier workers Williams et al;Ivan & Milica;Ben-Gal et al;Ludinghausen et al, 2003). In 23.1% of the hearts in the present study the proximal segment of the TCA sent branches to the conducting system.…”

Section: Prevalencesupporting

confidence: 93%

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Prevalence and Distribution of the Third Coronary Artery in Kenyans

et al. 2007

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SUMMARY:A third coronary artery (TCA) has been defined as a direct branch from the right aortic sinus (RAS) that contributes to the vascularization of the infundibulum of the right ventricle (RV). The distribution of this artery may be important in surgical procedures and in understanding the extent and progression of acute myocardial infarction. Its reported prevalence however shows ethnic disparity. The aim of the study was describe the prevalence and distribution of the third coronary artery in a Kenyan population. 148 cadaveric and postmortem human adult hearts obtained from the Department of Human Anatomy, University of Nairobi, and the Chiromo and Nairobi city mortuaries were used after an ethical approval. The hearts were studied by gross dissection for the prevalence and topographical anatomy of the TCA. Data was coded and analyzed using SPSS. The TCA is present in 35.1% of the heart specimens. It was variably distributed to the conducting system (23%), anterior wall of the RV (100%), interventricular septum (IVS) (51.9%) and the apex of the heart (5.8%). The TCA, with substantial contribution to cardiac vascularization, may be present in about a third of the Kenyans. It may constitute a significant collateral circulation to apical and septal perfusion. Interpretation of signs and symptoms of coronary occlusion should therefore consider possible contribution of this vascular channel.

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Section: Prevalencesupporting

confidence: 93%

“…The reported prevalence of the TCA suggests ethnic variability (Schlesinger et al;Miyazaki & Kato, 1988;Ivan & Milica, 2004). Although its distribution is relatively unexplored, this artery may supply variable parts of the anterior wall of the RV and the IVS (Sahni & Jit, 1990;Ben-Gal. et al, 1997;von Ludinghausen & Ohmachi, 2001).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Distribution of the Third Coronary Artery in Kenyans

et al. 2007

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“…Although it supplies infundibulum of right ventricle, this artery may supply variable part of the anterior wall of the right ventricle and interventricular septum [11][12][13][14].…”

Section: Resultsmentioning

confidence: 99%

Study of Third Coronary Artery in Adult Human Cadaveric Hearts

Dhobale

Puranik

Mudiraj

et al. 2015

JCDR

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“…In contrast to our study, in the latter study, LVEF was similar in both groups. There are some reports regarding the protective role of the conus branch of the right coronary artery on interventricular septum and STE of V1 or right precordial leads (21). Anatomical variations of this branch may be an important confounding factor leading to different results regarding the frequency of arrhythmias, heart failure and LVEF in various studies.…”

Section: Discussionmentioning

confidence: 99%

ST-Segment Elevation in the Right Precordial Leads in Patients with Acute Anterior Myocardial Infarction

Pourafkari¹,

Joudi²,

Ghaffari³

et al. 2016

Balkan Med J

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Background: Elevation of ST segment in leads V3R/ V4R, which is commonly encountered in right ventricular myocardial infarction, may also occur in patients with anterior ST elevation myocardial infarction (STEMI). However, the clinical impact of this finding in the setting of anterior myocardial infarction is not well understood. Aims: We aimed to investigate the prognostic value of ST segment elevation in leads V3R/V4R in patients with first acute anterior myocardial infarction. Study Design: Prospective cohort study. Methods: Right precordial leads V3R/V4R were recorded in 111 patients admitted with first time anterior myocardial infarction. Patients were allocated into two groups based on the presence or absence of ST elevation in leads V3R/V4R. Demographic, biochemical and echocardiographic data, as well as the angiographic information, were recorded. In-hospital and 3 month mortality, and major adverse cardiac events (MACE), death, heart failure and ventricular dysrhythmia were also compared. Results: ST elevation in lead V3R or V4R was present in 72 out of 111 patients (64.9%). Involvement of the proximal part of the left anterior descending (LAD) artery was not different in the two groups (44.4% of patients with elevation vs. 53.8% of patients without elevation, p=0.22). Post-myocardial infarction complications, mortality and major adverse cardiac events were similar in the two groups. Left ventricular ejection fraction (LVEF) was significantly lower in patients with ST elevation in V3R/V4R (35 %±8 vs. 38 %±8, p=0.02). Twenty three out of 111 patients (20.7%) developed heart failure, which was similar in the two groups [16 (22.2%) of patients with ST elevation vs. 7 (17.9%) of patients without ST elevation, p=0.39]. Conclusion: Although ST elevation in V3R/V4R can be present in patients with left anterior descending artery occlusion, it does not seem to predict the prognosis. Lower left ventricular ejection fraction in this group may play a role in the long-term prognosis; however, this issue needs further investigation.

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Importance of the Conal Branch of the Right Coronary Artery in Patients With Acute Anterior Wall Myocardial Infarction: Electrocardiographic and Angiographic Correlation

Cited by 62 publications

References 28 publications

Prevalence and Distribution of the Third Coronary Artery in Kenyans

Prevalence and Distribution of the Third Coronary Artery in Kenyans

Study of Third Coronary Artery in Adult Human Cadaveric Hearts

ST-Segment Elevation in the Right Precordial Leads in Patients with Acute Anterior Myocardial Infarction

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