Anomalous origin of the left coronary artery from the opposite breast. Pathological case

Main Article Content

Jesús Salvador Valencia-Sánchez
Alejandra Moreno-Vázquez
Belinda González-Díaz
Beatriz Elizabeth Valencia-Palacios

Keywords

Coronary sinus, Heart defects, congenital, Coronary artery

Abstract

Background: Anomalous origin of the left coronary artery from right coronary sinus ACAOS is characterized because the left main coronary artery anomalously originates from the right sinus of valsalva aortic coronary and whose journey can follow four different paths to the left side of the heart. 

Case report: a 73 years old men, who was admitted at the hospital for chest pain of oppressive type, intensity 10/10 with irradiation to left arm and neck, accompanied by diaphoresis and nausea. The diagnosis was an ischemic syndrome acute coronary undergo therapy thrombolytic, the evolution was not satisfactory due to different complications that led to the death.

Conclusions: The diagnosis of anomalous coronary artery left the opposite breast origin (ACAOS), is established basically through methods of diagnostics as computed cardiac angiography or cardiac catheterization as part of the approach of an acute coronary ischemic syndrome that allow to establish the morphological characteristics of coronary as the different anatomic variants and their characteristics with respect to adjacent structures.

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References

Lim JC, Beale A, Ramcharitar S; Medscape. Anomalous origination of a coronary artery from the opposite sinus. Nat Rev Cardiol. 2011;8(12):706-19.

 

Angelini P, Velasco JA, Flamm S. Coronary anomalies: incidence, pathophysiology and clinical relevance. Circulation. 2002;105(20):2449-54.

 

Click RL, Holmes DR Jr, Vlietstra RE, Kosinski AS, Kronmal RA. Anomalous coronary arteries: location, degree of atherosclerosis and effect on survival: a report from the Coronary Artery Surgery Study. J Am Coll Cardiol. 1989;13(3):531-7.

 

Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arterioography. Cathet Cardiovasc Diagn. 1990;21(1):28-40.

 

Alexander RW, Griffith GC. Anomalies of the coronary arteries and their clinical significance. Circulation. 1956;14(5):800-5.

 

Angelini P. Coronary artery anomalies. an entity in search of an identity. Circulation. 2007;115(10):1296-305.

 

Angelini P, Villason S, Chan AV, Diez JC. Normal and anomalous coronary arteries in humans. In: Angelini P, Fairchild VD, eds. Coronary artery anomalies: A comprehensive approach. Philadelphia: Lippincott Williams & Wilkins; 1999.

 

Ishikawa T, Brandt PW. Anomalous origin of the left main coronary artery from the right anterior aortic sinus: angiographic definition of anomalous course. Am J Cardiol. 1985;55(6):770-6.

 

Roberts WC, Shirani J. The four subtypes of anomalous origin of the left main coronary artery from the right aortic sinus (or from the right coronary artery). Am J Cardiol. 1992;70(1):119-21.

 

Moodie DS, Gill C, Loop FD, Sheldon WC. Anomalous left main coronary artery originating from the right sinus of Valsalva: pathophysiology, angiographic definition and surgical approaches. J Thorac Cardiovasc Surg. 1980;80(2):198-205.

 

Mustafa I, Gula G, Radley-Smith R, Durrer S, Yacoub M. Anomalous origin of the left coronary artery from the anterior aortic sinus: a potential cause of sudden death. Anatomic characterization and surgical treatment. J Thorac Cardiovasc Surg. 1981;82 (2):297-300.

 

Leberthson RR, Dinsmore RE, Bharati S, Rubenstein JJ, Caulfield J, Wheeler EO, et al. Aberrant coronary artery origin from the aorta. Diagnosis and clinical significance. Circulation. 1974;50(4):774-9.

 

Ogden JA. Congenital anomalies of the coronary arteries. Am J Cardiol. 1970;25(4):474-9.

 

Chaitman BR, Lespérance J, Saltiel J, Bourassa MG. Clinical, angiographic and hemodynamic findings in patients with anomalous origin of the coronary arteries. Circulation. 1976;53(1):122-31.

 

Akkus NI, Siddiqui TS, Prabhu S. Images in cardiology: Anomalous origin of a diseased left main coronary artery from the right sinus of valsalva. Clin Cardiol 2002;25(10):489. 

 

Baltaxe HA, Wixson D. The incidence of congenital anomalies of the coronary arteries in the adult population. Radiology. 1977;122(1):47-52.

 

Kimbiris D, Iskandrian AS, Segal BL, Bemis CE. Anomalous aortic origin of coronary arteries. Circulation. 1978;58(4):606-15.

 

Roberts WC, Dicicco BS, Waller BF, Kishel JC, McManus BM, Dawson SL, et al. Origin of the left main from the right coronary artery or from the right aortic sinus with intramyocardial tunneling to the left side of the heart via the ventricular septum. The case against clinical significance of myocardial bridge or coronary tunnel. Am Heart J. 1982;104 (2 Pt. 1):303-5.

 

Frommelt PC, Sheridan DC, Berger S, Frommelt MA, Tweddell JS. Ten-year experience with surgical unrrofing of anomalous aortic origin of a coronary artery from the opposite sinus with an interarterial course. J Thorac Cardiovasc Surg. 2011;142(5):1046-51.

 

Cheitlin MD, MacGregor J. Congenital anomalies of coronary arteries: role in the pathogenesis of sudden cardiac death. Herz. 2009;34(4):268-79.

 

Opolski MP, Pregowski J, Kruk M, Witkowsky A, Kwiecinska S, Lubienska E, et al. Prevalence and characteristics of coronary anomalies originating from the opposite sinus of Valsalva in 8,522 patients referred for coronary computed tomography angiography. Am J Cardiol. 2013;111(9):1361-7.