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[Incidental detection of coronary artery anomalies]
Insights
Anomalous origin of the coronary arteries, though congenital, often presents late with nonspecific symptoms. Diagnosis requires selective coronarography, especially when associated with other cardiac conditions.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Diagnostic Imaging
Background:
- Anomalous origin of the coronary arteries (AOCA) is a congenital condition.
- Clinical manifestations can be nonspecific and appear later in life.
- Associated conditions can influence presentation and diagnosis.
Purpose of the Study:
- To analyze the clinical findings of patients with anomalous origin of the coronary arteries.
- To evaluate the diagnostic methods used for AOCA.
- To understand the impact of associated diseases on AOCA presentation.
Main Methods:
- Retrospective study of 15 patients with AOCA.
- Analysis of clinical data from 5500 coronary arteriograms.
- Review of associated conditions including coronary disease, rheumatic disease, and atrial septal defect.
Main Results:
- AOCA was diagnosed in 15 patients (18-58 years old).
- 4 anomalies were isolated; 11 were associated with other conditions.
- Manifestations appeared between ages 16-54, with nonspecific findings.
Conclusions:
- Anomalous origin of the coronary arteries can present with nonspecific clinical and diagnostic findings.
- Diagnosis is confirmed by selective coronarography.
- Associated diseases complicate the clinical picture and diagnostic interpretation.
Abstract:
A retrospective study is presented analyzing the clinical findings in 15 patients in the age range of 18-58 years (12 men, 3 women) with anomalous origin of the coronary arteries diagnosed from 5500 coronary arteriograms performed in the authors' institute IKEM. In 4 patients the anomaly was isolated, in 11 patients associated, and that in 6 with coronary disease, in 3 with rheumatic disease, and in 2 patients with atrial septal defect. Although the disease is congenital, its manifestations appeared only in the 16th to 54th year of life, presenting a nonspecific clinical picture, physical, ECG and XR findings. Changes in the ergometric test and left ventriculography were determined by the associated disease. Diagnosis of the anomaly was established by selective coronarography.