Journal of the Saudi Heart Association最新文献

{"title":"<i>Comments on the Letter:</i> Strengthening the Evidence Base for Pediatric Cardiac Computed Tomography: Statistical and Technological Considerations.","authors":"Lamia G Jamjoom, Razan K Daghistani","doi":"10.37616/2212-5043.1518","DOIUrl":"10.37616/2212-5043.1518","url":null,"abstract":"","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 3","pages":"6"},"PeriodicalIF":1.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Quantitative Coronary Analysis as Compared with Instantaneous Wave-Free Ratio in Intermediate Coronary Lesions: A Prospective Vessel-Level Study.","authors":"Tamer M Ragab, Khaled A Alkhashab, Mohamed Z Hussain, Ibrahim M Nosseir, Marwa S Sayed, Waleed K A Salem","doi":"10.37616/2212-5043.1522","DOIUrl":"10.37616/2212-5043.1522","url":null,"abstract":"<p><strong>Background: </strong>Instantaneous wave-free ratio (IFR) represents a new vasodilator-free innovative approach which is considered as a gold standard for functional assessment of the hemodynamic significance of intermediate coronary stenoses. Although relatively safe, iFR is still an invasive procedure that has its potential hazards, complications and cost. Two-dimensional quantitative coronary analysis (2D-QCA) is a non-invasive technique that has emerged robustly as an excellent and attractive tool for delineating coronary anatomy.</p><p><strong>Aims: </strong>To assess the ability of two-dimensional quantitative coronary analysis (2D-QCA) to guide decision-making for quantification of severity of intermediate coronary stenoses (40-80% diameter stenosis) in each of the three main coronary vessels, by evaluating its accuracy in predicting true instantaneous wave-free ratio (iFR) results.</p><p><strong>Methods and results: </strong>2D-QCA followed by iFR were performed for intermediate coronary lesions (40-80% diameter stenosis by visual assessment) discovered during coronary angiography. 2D-QCA was used to measure MLA, MLD and lesion length. This was followed by iFR measurement for the same lesion. 2D-QCA was then compared to the iFR measurements in order to assess its accuracy in prediction of true iFR result. A total of 277 intermediate lesions (155 LAD, 67 LCX, 55 RCA) in 209 vessels from 166 patients were analyzed. Males comprised ~68% of cases; mean ages were 53.3 ± 8.2 (LAD), 55.7 ± 8.9 (LCX), and 56.0 ± 8.8 years (RCA). Disagreement between modalities occurred mostly in LAD (24.5%), followed by RCA (21.8%) and LCX (14.9%). Per-vessel QCA accuracy (AUC) for predicting iFR was highest in LCX (78.5%), then RCA (72.2%), and lowest in LAD (66.6%) (all p < 0.005). Optimal QCA stenosis area cutoffs were 50.5% (LCX), 52.5% (RCA), and 53.5% (LAD), with sensitivities of 72.0%, 62.1%, and 63.2%, and specificities of 69.0%, 65.4%, and 65.8%, respectively.</p><p><strong>Conclusion: </strong>2D-QCA can be a practical tool that bears the potential of improving angiography-based assessment of intermediate lesions regarding its prediction for functional significance without any additional costs, especially when invasive functional assessment methods are not available or contraindicated. Although, this would minimize the burden and the time of invasive procedure, 2D-QCA cannot totally replace invasive functional assessment (iFR, FFR) of intermediate coronary stenoses especially in LAD intermediate lesions.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 3","pages":"5"},"PeriodicalIF":1.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening the Evidence Base for Pediatric Cardiac CT: Statistical and Technological Considerations.","authors":"Faizan Faisal","doi":"10.37616/2212-5043.1519","DOIUrl":"10.37616/2212-5043.1519","url":null,"abstract":"","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 3","pages":"7"},"PeriodicalIF":1.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13603729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2026 Focused Update of the Saudi Heart Association Guidelines on Best Practices in the Management of Chronic Coronary Syndromes.","authors":"Owayed Alshammeri, Halia Alshehri, Shukri Alsaif, Mirvat Alasnag, Fatema Qaddoura, Fahad Alqahtani, Yosra A A Turkistani, Walid Alharbi, Adel Tash, Mohammad Alshehri, Khalid Al Faraidy, Waleed Alhabeeb","doi":"10.37616/2212-5043.1516","DOIUrl":"https://doi.org/10.37616/2212-5043.1516","url":null,"abstract":"<p><strong>Background: </strong>Chronic coronary syndromes (CCS) continue to impose a substantial clinical and economic burden in Saudi Arabia. Since publication of the 2022 Saudi Heart Association (SHA) CCS guidelines, important advances have emerged in diagnosis, pharmacotherapy, cardiometabolic risk reduction, antiplatelet management, and revascularization. This 2026 focused update selectively revises and clarifies key recommendations to reflect these advances within the Saudi context.</p><p><strong>Methods: </strong>A multidisciplinary SHA expert panel conducted a structured review of randomized trials, meta-analyses, and relevant international guidance published since 2022. Updates were restricted to areas with substantive new evidence or evolving clinical practice. Recommendations were formulated through expert consensus in accordance with SHA methodological standards. This document complements the 2022 guideline and does not replace it.</p><p><strong>Results and conclusions: </strong>This focused update advances a more personalized, risk-driven approach to CCS management. Diagnostic algorithms now explicitly integrate pre-test probability, reinforce coronary computed tomography angiography as the preferred initial modality in low-to-intermediate probability, and refine the positioning of functional stress imaging. Residual risk assessment and preventive strategies are also strengthened. Importantly, this update introduces a dedicated diagnostic and management framework for angina and ischemia with non-obstructive coronary arteries (ANOCA/INOCA), emphasizing endotype-specific evaluation and targeted therapy for this historically under-recognized population. Anti-anginal therapy positions beta-blockers and calcium channel blockers as equivalent first-line agents, upgrades long-acting nitrates, and integrates ranolazine, ivabradine, and trimetazidine as evidence-based add-on options. Antiplatelet guidance emphasizes individualized dual antiplatelet therapy duration after percutaneous coronary intervention (PCI), early de-escalation strategies, and selective use of P2Y12 inhibitor monotherapy. Lipid management and cardiovascular risk reduction options are now expanded and revascularization recommendations are restructured. Collectively, these updates strengthen the delivery of contemporary, evidence-based, and patient-centered CCS care and provide a clear framework for implementation across diverse healthcare settings.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 3","pages":"4"},"PeriodicalIF":1.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149245184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saudi Heart Association Scientific Statement on Cardiovascular-Kidney-Liver-Metabolic (CKLM) Syndrome.","authors":"Waleed Alhabeeb, Abdulhalim J Kinsara, Ahmed Mitwalli, Ali A Alshehri, Faisal Abaalkhail, Ismail Raslan, Khalid Aljohani, Mohammed Arafah, Muthana Al Sahlawi, Saud Alsifri, Suleiman M Kharabsheh","doi":"10.37616/2212-5043.1510","DOIUrl":"10.37616/2212-5043.1510","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular, kidney, metabolic, and liver diseases are closely interconnected and frequently coexist. While the cardiovascular-kidney-metabolic (CKM) framework provides a unified model, increasing evidence supports a central role for hepatic disease, particularly metabolic dysfunction-associated steatotic liver disease (MASLD), in this continuum. The Saudi Heart Association (SHA) therefore aimed to introduce the cardiovascular-kidney-liver-metabolic (CKLM) syndrome as an expanded framework and provide expert guidance on its pathophysiology, staging, screening, and management, with relevance to the Saudi population.</p><p><strong>Methods: </strong>A multidisciplinary expert panel convened under the auspices of the SHA conducted a comprehensive, non-systematic literature review and developed consensus-based recommendations through iterative discussion and critical appraisal of the evidence.</p><p><strong>Results and conclusions: </strong>CKLM syndrome is a progressive multisystem disorder driven by shared mechanisms, including insulin resistance, inflammation, and fibrosis, with bidirectional interactions across cardiovascular, kidney, metabolic, and hepatic domains. A stage-based framework is proposed to support risk stratification and guide management. Therapeutic strategies include agents with established cardiovascular, kidney and metabolic benefits, with emerging evidence supporting combination approaches. The high prevalence and coexistence of CKLM-related conditions in Saudi Arabia highlight the need for integrated care. The CKLM framework extends existing models by incorporating hepatic disease into the cardiometabolic-kidney continuum, enabling a more comprehensive approach to risk assessment and management. Multidisciplinary, stage-based strategies are recommended as they are expected to improve outcomes, although further validation is required.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"23"},"PeriodicalIF":1.4,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Heart Failure-Specific Disease Management Programs and Patient Care in Saudi Arabia: A Saudi Heart Association Position Statement.","authors":"Abeer Bakhsh, Fakhr Al Ayoubi, Fayez Elshaer, Hanan B Albackr, Hanin A Bogari, Ibrahim Jelaidan, Ismail Raslan, Kamal Al Ghalayini, Maryam Alqaseer, Waleed AlHabeeb","doi":"10.37616/2212-5043.1507","DOIUrl":"10.37616/2212-5043.1507","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) represents a major and growing health burden in Saudi Arabia, with high morbidity, frequent hospitalizations, and substantial system-level costs. Despite advances in guideline-directed medical therapy, gaps in diagnosis, care coordination, and longitudinal management persist. Structured, multidisciplinary heart failure-specific disease management programs (HF-DMPs) have been shown to improve outcomes and healthcare efficiency, yet their implementation remains inconsistent across the Kingdom.</p><p><strong>Methods: </strong>The Saudi Heart Association (SHA) convened a multidisciplinary expert panel to develop a national position statement on HF-DMPs. Recommendations were formulated through structured consensus, informed by a comprehensive review of international guidelines, clinical trials, real-world evidence, and Saudi-specific data.</p><p><strong>Results and conclusions: </strong>The SHA recommends a patient-centered, multidisciplinary HF-DMP framework aligned with disease stage and institutional capacity. Core components include structured referral and return-of-care pathways, integration of primary care as longitudinal care owners, optimized use of multidisciplinary teams, and scalable models incorporating virtual care and home-based services. Special populations, including cardio-oncology, pregnancy-associated HF, and cardiomyopathies, are addressed through adaptive multidisciplinary pathways. Performance indicators and quality metrics are proposed to support benchmarking and continuous improvement. Crucially, this framework is designed to synergize with the Kingdom's Model of Care, ensuring that these clinical recommendations also offer a practical tool for the new healthcare system. Implementation of structured, capacity-based HF-DMPs is recommended as a pragmatic and scalable approach to enhance care coordination, optimize resource utilization, and reduce preventable HF morbidity and hospitalization at a national level.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"24"},"PeriodicalIF":1.4,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-Port Totally Endoscopic Mitral Valve Replacement Through a Prosthesis-Sized Working Incision with Posterior Subvalvular Preservation.","authors":"Cao D Khang, Tran D Quang, Phan Q Thuan, Vuong N Minh, Pham T V Chuong, Nguyen H Dinh","doi":"10.37616/2212-5043.1517","DOIUrl":"10.37616/2212-5043.1517","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility and early outcomes of totally endoscopic non-robotic mitral valve replacement using a double-port DCT approach with posterior subvalvular preservation.</p><p><strong>Methods: </strong>In this single-center retrospective observational study, 76 consecutive patients underwent totally endoscopic non-robotic mitral valve replacement between November 2023 and December 2025. The DCT approach was defined by exclusive endoscopic visualization, no rib spreading, a camera port and prosthesis-sized working incision placed in the same intercostal space, and thoracoscopic intracardiac instrumentation. Posterior ventricular-annular continuity was preserved whenever feasible by posterior leaflet preservation, native chordal preservation, or artificial chordal reimplantation after leaflet resection. Outcomes were reported descriptively with 95% confidence intervals.</p><p><strong>Results: </strong>Mechanical prostheses were implanted in 46 patients (60.5%) and bioprostheses in 30 (39.5%). Mean skin incision length was 3.8 ± 0.5 cm. Mean cardiopulmonary bypass and aortic cross-clamp times were 148.3 ± 38.6 and 101.9 ± 32.0 minutes, respectively. There was 1 early non-cardiac death (1.3%; 95% CI, 0.03%-7.1%), no late death, and no mitral valve reoperation (0%; 95% CI, 0%-4.7%). No moderate or severe paravalvular regurgitation was observed during early echocardiographic follow-up. Mean follow-up was 9.7 ± 6.0 months. Freedom from prosthetic valve-related adverse events was 98.6% (95% CI, 90.6%-99.8%) at 6 months and 95.2% (95% CI, 80.1%-98.9%) at 12 months. The 24-month estimate was identical but was based on few patients at risk and should be interpreted cautiously.</p><p><strong>Conclusions: </strong>The double-port DCT approach was technically feasible and was associated with acceptable early clinical and echocardiographic outcomes. Because of the retrospective single-center design, small sample size, absence of a comparator group, and short follow-up, these findings should be interpreted as feasibility data rather than evidence of superiority.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 3","pages":"3"},"PeriodicalIF":1.4,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Candida Albicans Purulent Pericarditis Complicated by Cardiac Tamponade in a Critically Ill Burn Patient: A Case Report.","authors":"Mutaz Althobaiti, Abdulrahman Alqahtani, Faisal Alanazi, Mohammad S Alotaibi, Ibrahim Bahabri, Shikah Alsuwaid, Turki Almutairi, Fawaz Almutairi","doi":"10.37616/2212-5043.1515","DOIUrl":"https://doi.org/10.37616/2212-5043.1515","url":null,"abstract":"<p><p>Candida pericarditis is a rare, life-threatening complication of invasive candidiasis, associated with high mortality. We report this case of a young woman with 60% body surface area burn, multidrug-resistant polymicrobial sepsis, and multiorgan failure who developed Candida albicans pericarditis complicated by cardiac tamponade. Despite urgent pericardiocentesis and escalation of antifungal therapy, she ultimately progressed to refractory shock and multiorgan failure. This case illustrates the diagnostic challenge and therapeutic limitations of fungal pericarditis in critically ill host, and underscores the importance of maintaining a high index of suspicion in burn patients with multisite Candida colonization and prolonged antibiotic exposure.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 3","pages":"2"},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics, Microbiology, and In-Hospital Outcomes of Infective Endocarditis at a Tertiary Cardiac Center in Saudi Arabia: A Retrospective Cohort Study.","authors":"Hussain M Alhassan, Zainab A Al Hubail, Zahra M Alshakhs, Sireen O Takrouni, Fatimah A Al Hussain, Hussain A AlQahtani, Ammar A Binammar, Beenish Mukhtar, Muhammad A Shah","doi":"10.37616/2212-5043.1512","DOIUrl":"https://doi.org/10.37616/2212-5043.1512","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) carries high morbidity and mortality, and its epidemiology in Saudi Arabia reflects a transition in which rheumatic and prosthetic valve disease coexist. Contemporary single-center data describing the clinical profile, microbiology, and in-hospital outcomes of IE in this setting remain limited.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study at a tertiary cardiac center in Riyadh, Saudi Arabia, including 102 patients with IE diagnosed between October 2020 and December 2024, classified using the modified Duke criteria. Variables were analyzed descriptively. Proportions are reported with 95% confidence intervals (CI; Wilson method) against the number of patients with available data, and missing data are reported as an explicit category. The study is reported in accordance with the STROBE statement.</p><p><strong>Results: </strong>The mean age was 46.7 ± 19.2 years (median 48, IQR 34-62), and 56 patients (54.9%, 95% CI 45.2-64.2) were male. The cardiac substrate was heterogeneous: rheumatic heart disease 32.4% (95% CI 24.1-41.9), prosthetic valve disease 30.4% (95% CI 22.3-39.9), degenerative valve disease 18.6% (95% CI 12.3-27.3), and congenital heart disease 14.7% (95% CI 9.1-22.9). Blood cultures were documented in 92 patients, with positivity in 52 (56.5%, 95% CI 46.3-66.2) and a culture-negative rate of 43.5% (95% CI 33.8-53.7). All-cause in-hospital mortality was 24.5% (24/98; 95% CI 17.0-33.9). ICU admission was required in 56.3% (49/87; 95% CI 45.9-66.3) and cardiac surgery in 38.0% (30/79; 95% CI 28.1-49.0).</p><p><strong>Conclusion: </strong>IE at this center presents across a heterogeneous cardiac substrate with substantial in-hospital mortality. A high culture-negative rate and considerable missingness in this retrospective dataset limit precision; findings should be regarded as descriptive and hypothesis-generating. Prospective, protocolized data with systematic long-term follow-up are needed.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"20"},"PeriodicalIF":1.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Atrial Appendage Mimicking Coronary Aneurysm and Thrombus on Echocardiography in a Child with Kawasaki Disease.","authors":"Anhar A Baeshen, Riad Abouzahr, Jameel Alata","doi":"10.37616/2212-5043.1514","DOIUrl":"https://doi.org/10.37616/2212-5043.1514","url":null,"abstract":"<p><strong>Background: </strong>The left atrial appendage (LAA) is an embryologically distinct structure with anatomical features that may mimic pathological findings on echocardiography. In Kawasaki disease, this resemblance can cause diagnostic confusion with coronary artery aneurysm or thrombus.</p><p><strong>Clinical presentation: </strong>A 7-year-old boy presented with fever lasting more than five days and cervical lymphadenopathy following a viral illness. Kawasaki disease was suspected. Transthoracic echocardiography suggested an abnormality of the left coronary artery with possible thrombus, and the patient was started on aspirin, clopidogrel, and apixaban. Coronary computed tomography angiography demonstrated normal coronary origins, course, and caliber, confirming the suspected lesion to be the LAA.</p><p><strong>Conclusion: </strong>The LAA may course adjacent to the left coronary artery and mimic a coronary aneurysm. Multimodality imaging is essential for accurate diagnosis.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 3","pages":"1"},"PeriodicalIF":1.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}