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Triple coronary pathologies complicated by acute cholecystitis

Mohammad Hassan Nemati1

  • 1Department of Cardiac Surgery, Faghihi Hospital, Shiraz University of Medical Sciences, Zand Street, Shiraz, Iran. nemati_mhs@yahoo.com

Interactive Cardiovascular and Thoracic Surgery
|April 10, 2010
PubMed

Insights

This study reports the first case of a patient with three coronary pathologies—atherosclerosis, myocardial bridge, and aneurysm—and acute cholecystitis, successfully treated with simultaneous surgery.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Gastroenterology

Background:

  • Coronary atherosclerosis, myocardial bridges, and coronary aneurysms are distinct causes of myocardial ischemia.
  • Patients with cardiac ischemia are susceptible to complications like acute cholecystitis.

Observation:

  • A 39-year-old male presented with chest pain and diaphoresis, requiring coronary artery bypass grafting (CABG).
  • He had severe right coronary artery stenosis, left circumflex artery aneurysm, and a left anterior descending artery myocardial bridge.
  • The patient developed acute cholecystitis preoperatively.

Findings:

  • Simultaneous cholecystectomy and CABG were performed.
  • This represents the first reported case of a single patient with three distinct coronary pathologies and acute cholecystitis undergoing combined surgical management.

Implications:

  • Concurrent surgical intervention for complex coronary artery disease and acute cholecystitis is feasible.
  • This case highlights the importance of considering non-coronary emergencies in patients with severe coronary artery disease.
  • Management strategies may need to be individualized for patients presenting with multiple simultaneous conditions.

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