A Case of Malignant Course of Right Coronary Artery: Frequent Angina in Young Person

S. Purwowiyoto, S. P. Surya
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Abstract

Introduction:Congenital anomalous coronary artery is a rare condition, but it might be the biggest pitfall for cardiologist. It might be silent until the patient reach young adult and has high intensity activity. Symptomatic anomalous course of coronary artery has wide spectrum from asymptomatic until the lethal one.Case Ilustration: We present a case of young adult with activity-triggered atypical chest pain and diagnose with anomalous origin of right coronary artery (RCA) from the left coronary sinus with inter-arterial course between the aorta and the main pulmonary artery that was detected by CT coronary angiography. This anomaly has been called malignant course RCA.Discussion:Coronary artery anomaly is a congenital condition. Most of the cases are remain asymptomatic. This condition also one of the most cause for sudden cardiac death because the coronary artery examination is not regularly done. Nevertheless, during high intense activity, it will be symptomatic and might be lethal.Conclusion:Diagnose coronary artery anomalies might be tricky and cardiologist must be aware with this. More devastating, no firm guideline in treatment of right anomalous coronary artery from opposite sinus.
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青年人右冠状动脉恶性病程:常发心绞痛1例
简介:先天性冠状动脉异常是一种罕见的疾病,但它可能是心脏病专家最大的陷阱。它可能是沉默的,直到患者达到年轻的成年人,并有高强度的活动。冠状动脉症状性异常过程从无症状到致死性异常具有广泛的谱系。病例说明:我们报告一位年轻的成年人,因活动引发的非典型胸痛,并诊断为右冠状动脉异常起源(RCA),从左冠状动脉窦,并在主动脉和肺动脉主动脉之间的动脉间路线,通过CT冠状动脉造影检测。这种异常被称为恶性病程RCA。讨论:冠状动脉异常是一种先天性疾病。大多数病例仍无症状。由于冠状动脉检查不定期,这种情况也是心源性猝死的最主要原因之一。然而,在高强度活动期间,它将出现症状并可能致命。结论:冠状动脉异常的诊断可能是一个棘手的问题,心脏科医生必须意识到这一点。更严重的是,在治疗右冠状动脉异位时,没有明确的指导方针。
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