Anomalous left coronary artery arising from the right sinus of Valsalva causing angina pectoris
Panagiotis Kastanis1, Vicens Marti, Macia Gotsanayidou
1Hospital de Sant Pau, Barcelona, Spain.
Journal of Cardiovascular Medicine (Hagerstown, Md.)
|April 23, 2009
Insights
A rare coronary artery anomaly, the left coronary artery originating from the right sinus of Valsalva, caused effort angina. Surgical grafting improved patient symptoms.
Area of Science:
- Cardiology
- Medical Imaging
- Surgical Innovation
Background:
- Congenital heart anomalies can present with diverse clinical manifestations.
- Anomalous coronary artery origins are a significant cause of cardiac events.
- Effort angina can be a symptom of underlying coronary artery disease or anomalies.
Observation:
- A patient presented with exertional chest pain suggestive of myocardial ischemia.
- Diagnostic workup revealed an anomalous left coronary artery originating from the right sinus of Valsalva.
- Magnetic resonance imaging (MRI) provided detailed anatomical assessment of the anomalous vessel.
Findings:
- Coronary angiography confirmed the anomalous origin of the left coronary artery.
- The patient underwent successful surgical revascularization using an internal mammary artery graft.
- Post-operative assessment indicated significant symptomatic improvement.
Implications:
- This case highlights the importance of considering coronary artery anomalies in patients with unexplained angina.
- Multimodality imaging, including MRI, is valuable for delineating complex coronary anatomy.
- Surgical intervention can effectively manage symptoms and improve outcomes in selected cases of coronary artery anomalies.
Abstract:
We present a patient with an anomalous left coronary artery arising from the right sinus of Valsalva with effort angina. Diagnosis was made by coronary angiography. The course of the proximal segment was assessed with magnetic resonance imaging (MRI). An internal mammary artery was successfully grafted with symptomatic improvement.
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