Intra-Atrial Right Coronary Artery and Anomalous Origin of Left Circumflex Artery Found Concurrently.

Journal of Medical Cases Pub Date : 2022-10-01 Epub Date: 2022-10-31 DOI:10.14740/jmc3986
Peter C Olson, Michael Cinelli, Hamfreth S Rahming, Marc Assaad, Jonathan Spagnola, James C Lafferty
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Abstract

Coronary artery anomalies (CAAs) are known to be anatomical aberrations in the origin and structure. Due to the diverse anatomical variants, surgeons and angiographers have struggled when faced with patients who have CAA. To frame the complicated issues surrounding CAA, we present a case of a young patient found to have two CAAs, concurrently on coronary computed tomography angiography (CCTA), while in the emergency room being evaluated for chest pain. Patient was medically observed without any invasive procedure since he was deemed to have low cardiovascular risk. Subsequently, literature on prevalence, as well as high risk findings are reviewed. Further studies to evaluate pharmacological, angiographic, and surgical interventions may have additional benefit for both patients and practitioners. Our aim is to help shed the light on difficulties cardiologists are facing during angiography. Additionally, our paper offers some guidance for how to evaluate and follow patients with similar findings into the future.

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心房内右冠状动脉与左旋动脉异常起源同时发现。
冠状动脉异常(CAAs)被认为是起源和结构上的解剖畸变。由于不同的解剖变异,外科医生和血管造影师在面对CAA患者时一直很挣扎。为了说明围绕CAA的复杂问题,我们报告了一个年轻患者的病例,在冠状动脉计算机断层血管造影(CCTA)中发现有两个CAAs,同时在急诊室接受胸痛评估。由于认为患者心血管风险较低,因此对患者进行了医学观察,没有进行任何侵入性手术。随后,回顾了有关患病率的文献以及高风险的发现。进一步研究评估药理学、血管造影和手术干预可能对患者和医生都有额外的好处。我们的目的是帮助阐明心脏病专家在血管造影时面临的困难。此外,我们的论文为未来如何评估和跟踪有类似发现的患者提供了一些指导。
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