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Intercoronary connection and apical left ventricular hypertrophy: case report and review of the literature

H Panayiotou1, J M Perry, J W Norris

  • 1Department of Medicine, Vanderbilt University, School of Medicine, Nashville, Tennessee.

Catheterization and Cardiovascular Diagnosis
|September 1, 1991
PubMed

Insights

A cardiac catheterization revealed apical left ventricular hypertrophy and an unusual connection between the posterior descending artery and left anterior descending artery in a patient with chest pain.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Anatomy

Background:

  • Chronic chest pain and T wave inversion are common symptoms requiring investigation.
  • Cardiac catheterization is a key diagnostic tool for coronary artery disease.

Observation:

  • A 55-year-old man presented with chronic chest pain and new T wave inversion.
  • Cardiac catheterization revealed apical left ventricular hypertrophy.
  • A large intercoronary connection was identified between the posterior descending artery (PDA) and the left anterior descending (LAD) artery.

Findings:

  • The left anterior descending (LAD) artery appeared normal on initial assessment.
  • Selective angiography of the right coronary artery (RCA) demonstrated retrograde filling of the LAD artery.
  • This suggests a significant collateral circulation pathway.

Implications:

  • The findings highlight the importance of comprehensive coronary angiography, including assessment of collateral circulation.
  • Understanding such anomalous connections can refine diagnostic and therapeutic strategies for ischemic heart disease.
  • Further review of potential mechanisms and existing literature is warranted.

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