Two complex coronary artery abnormalities discovered after an acute coronary syndrome : A case report

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie Pub Date : 2024-11-08 DOI:10.1016/j.ancard.2024.101838

B. Bourlond , M. Dupré , SD. Qanadli , E. Eeckhout

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引用次数: 0

Abstract

Background

Complex coronary artery abnormalities (CAA) are rare findings with no established guideline for their management in asymptomatic patients.

Case summary

We report the case of a 49-year-old male patient, with no medical history, who was incidentally diagnosed for two congenital complex CAA during for the management of an acute coronary syndrome without ST elevation.

The coronary angiogram showed an acute atheromatous occlusion of the right coronary artery (RCA) that was treated by a drug-eluting stent.

Transcatheter angiograms as well as the coronary computed tomography (CT) also revealed an ectopic RCA arising from the left cuspid with an inter-arterial course, and a second left anterior descending artery emerging from the RCA with a retro-pulmonary course.

The present acute coronary syndrome was not in relation to his congenital disease but with an atheromatous disease. On 48 months of follow-up, the transthoracic echocardiography is normal and the patient remains asymptomatic despite the risk of sudden cardiac death and myocardial infarction.

Discussion

This case shows that CAA can be clinically silent for a long period of time without any correction. It highlights that ischemia in patients with CAA is not always due to the congenital disease. As patients seemed to remain at SCD risk despite surgical correction, not correcting the CAA might remain an alternative in asymptomatic adult patients.

查看原文本刊更多论文

急性冠状动脉综合征后发现的两处复杂冠状动脉异常：病例报告。

背景：病例摘要：我们报告了一例 49 岁男性患者的病例，该患者无病史，在治疗无 ST 间期抬高的急性冠状动脉综合征期间被意外诊断为两支先天性复杂 CAA。冠状动脉造影显示右冠状动脉（RCA）急性粥样硬化性闭塞，使用药物洗脱支架进行了治疗。经导管血管造影和冠状动脉计算机断层扫描（CT）还显示，有一条异位的 RCA 从左侧蝶骨处生成，动脉走向为动脉间走向，还有一条左前降支动脉从 RCA 处生成，走向为肺后走向。目前的急性冠状动脉综合征与他的先天性疾病无关，而是与动脉粥样硬化疾病有关。在48个月的随访中，经胸超声心动图检查结果正常，尽管存在心脏性猝死和心肌梗死的风险，但患者仍无症状：本病例表明，CAA 可在临床上长期无症状而不进行任何纠正。讨论：本病例表明，CAA 可在临床上长期沉默而不进行任何矫正，这突出表明 CAA 患者的心肌缺血并不总是由先天性疾病引起的。尽管进行了手术矫正，但患者似乎仍有发生 SCD 的风险，因此对于无症状的成年患者来说，不矫正 CAA 仍不失为一种选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annales de cardiologie et d'angeiologie 医学-外周血管病

CiteScore

0.60

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Organe scientifique de référence fondé en 1951, les Annales de cardiologie et d''angéiologie abordent tous les domaines qui intéressent quotidiennement les cardiologues et les angéiologues praticiens : neurologie et radiologie vasculaires, hémostase, diabétologie, médecine interne, épidémiologie et prévention. Les Annales de cardiologie et d''angéiologie sont indexées aux grandes bases de données et publient rapidement, et en conformité avec les normes internationales de publication scientifique, des articles en français sur la pathologie cardiaque.