Anomalous origin of the circumflex coronary artery--two case reports
Vanda Carmelo1, Júlia Toste, Susana Castela
1Serviço de Cardiologia, Hospital de Pulido Valente, Lisboa, Portugal. vcarmelo@sapo.pt
Insights
Congenital coronary artery anomalies, often involving the circumflex artery, affect 0.6-1.5% of patients. Multislice computed tomography aids in diagnosing these anomalies, which can lead to myocardial ischemia.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Congenital coronary artery anomalies are observed in 0.6-1.5% of patients undergoing coronary angiography.
- These anomalies commonly involve the circumflex artery, with variations in origin from the right sinus of Valsalva or right coronary artery.
- The most frequent anomaly is the absence of the left main coronary artery.
Observation:
- Conventional coronary angiography has limitations in determining the 3D course of anomalous coronary arteries.
- Multislice computed tomography (MSCT) offers non-invasive visualization of coronary arteries.
- MSCT provides more accurate information regarding the proximal course of anomalous vessels.
Findings:
- This study presents two cases of congenital circumflex coronary artery anomaly.
- Diagnosis was achieved using multislice computed tomography.
- MSCT effectively visualized the anomalous coronary artery anatomy.
Implications:
- Coronary artery anomalies, though often benign, can predispose to accelerated atherosclerosis and myocardial ischemia.
- Early and accurate diagnosis is crucial for managing patients with these conditions.
- Multislice computed tomography is a valuable tool for the non-invasive diagnosis and characterization of congenital coronary artery anomalies.
Abstract:
As shown in many series, congenital coronary artery anomalies are found in 0.6 to 1.5% of patients undergoing coronary angiography. Various types of coronary anomalies have been described, many involving the circumflex artery. The second most common anomaly is of the circumflex arising from the right sinus of Valsalva, while origin in the right coronary artery is also frequent. The most common anomaly is absence of the left main coronary artery, the anterior descending and circumflex arteries originating separately in the left coronary sinus. Such anomalies are usually benign, although earlier and more aggressive atherosclerosis is more likely than in normal coronaries and myocardial ischemia can result. Although rare, this can manifest as sudden death. Conventional coronary angiography may be unable to determine the three-dimensional course of the anomalous vessel. The development of multislice computed tomography and its application to cardiac imaging mean that it is now possible to visualize the coronary arteries non-invasively and to obtain more accurate information on their proximal course. We present two cases of congenital anomaly of the circumflex coronary artery diagnosed with the aid of multislice computed tomography.
More Related Videos
Related Concept Videos
01:21Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
01:26Coronary Artery Disease II: Pathophysiology
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Coronary Artery Disease I: Introduction
01:25Cardiovascular System Abnormal Findings II: Auscultation
Abnormal Heart Sounds
Gallops:
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations