A single, shared origin for all three coronary arteries from the right coronary cusp: a case report.
anomaly
case report
congenital
coronary computed tomographic angiogram
sudden death
unroofing
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
10 Jul 2020
10 Jul 2020
Historique:
received:
13
01
2020
accepted:
01
06
2020
entrez:
11
7
2020
pubmed:
11
7
2020
medline:
7
4
2021
Statut:
epublish
Résumé
Anomalous coronary arteries occur in less than 1% of the population and have been implicated in sudden cardiac and exercise-related death. The most common variant involves the left circumflex artery arising from a separate ostium than the left coronary artery. This case demonstrates a rare variation in which all three coronary arteries arise from a shared, single, ostium originating from the right coronary cusp. We report the case of a 63-year-old Caucasian man with a history of myocardial infarction, congestive heart failure, and atrial fibrillation who presented for syncope. Inpatient ischemic workup, including coronary angiography, demonstrated a rare coronary anomaly which included all three coronary arteries arising from a shared, single, ostium originating from the right coronary cusp. Our patient was treated conservatively with an option for coronary bypass if symptomatic. Surgical management is indicated in high-risk patients, but the optimal management for a nonmalignant, shared origin for all three coronary arteries has not been explored in detail.
Sections du résumé
BACKGROUND
BACKGROUND
Anomalous coronary arteries occur in less than 1% of the population and have been implicated in sudden cardiac and exercise-related death. The most common variant involves the left circumflex artery arising from a separate ostium than the left coronary artery. This case demonstrates a rare variation in which all three coronary arteries arise from a shared, single, ostium originating from the right coronary cusp.
CASE PRESENTATION
METHODS
We report the case of a 63-year-old Caucasian man with a history of myocardial infarction, congestive heart failure, and atrial fibrillation who presented for syncope. Inpatient ischemic workup, including coronary angiography, demonstrated a rare coronary anomaly which included all three coronary arteries arising from a shared, single, ostium originating from the right coronary cusp. Our patient was treated conservatively with an option for coronary bypass if symptomatic.
CONCLUSION
CONCLUSIONS
Surgical management is indicated in high-risk patients, but the optimal management for a nonmalignant, shared origin for all three coronary arteries has not been explored in detail.
Identifiants
pubmed: 32646481
doi: 10.1186/s13256-020-02422-9
pii: 10.1186/s13256-020-02422-9
pmc: PMC7350559
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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