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[Congenital coronary artery malformations and associated clinical syndromes (author's transl)]
Insights
Congenital coronary anomalies were found in 3.7% of patients with angina. These anomalies, without obstructive disease, were linked to typical angina symptoms in 2.44% of cases, suggesting a causal relationship.
Area of Science:
- Cardiology
- Medical Imaging
- Congenital Heart Disease
Background:
- Anginal syndrome is a common clinical presentation.
- Coronary arteriography is a key diagnostic tool for evaluating coronary artery disease.
- Congenital coronary anomalies are rare but can impact cardiac function.
Purpose of the Study:
- To determine the frequency of congenital coronary anomalies in patients presenting with anginal syndrome.
- To investigate the relationship between coronary anomalies and the development of angina.
- To assess the clinical significance of these anomalies in the absence of obstructive coronary disease.
Main Methods:
- Retrospective analysis of coronary arteriograms from patients evaluated for angina.
- Categorization of identified coronary anomalies (fistula, aneurysms, single ostium, hypoplasia, hyperplasia).
- Correlation of anomaly presence with clinical symptoms, stress test results, and left ventricular function (cineventriculography).
Main Results:
- Congenital coronary anomalies were identified in 3.7% of patients undergoing coronary arteriography for angina.
- In 2.44% of cases, anomalies were present without significant obstructive coronary disease.
- Specific anomalies included coronary fistula, aneurysms, single ostium, and hypoplasia/hyperplasia of major coronary arteries.
- Typical angina and positive stress tests were observed in most patients with anomalies.
- Left ventricular asynergy was noted in 16 patients.
Conclusions:
- Congenital coronary anomalies can be a direct cause of anginal syndrome, even without obstructive coronary disease.
- The observed anomalies were frequently associated with typical angina symptoms and objective signs of cardiac stress.
- Coronary arteriography is crucial for diagnosing these anomalies and understanding their role in angina.
Abstract:
In 34 cases, corresponding to 3,7% of all patients underwent coronary arteriography for evaluation of anginal syndrome in our laboratory, it was observed a congenital coronary anomaly on their angiograms. The purpose of this paper is to verify the frequency of coronary anomalies and to evaluate relations existing between these anomalies and anginal syndrome. Coronary arteriograms, in 22 cases (2,44%), revealed exclusively; the presence of a coronary anomaly without occlusive coronary disease, which might per se justify angina. They were distributed as follows : 5 with coronary fistula, 2 with coronary aneurysms, 2 cases with single ostium and finally, 13 subjects with hypoplasia of one of the three major coronary arteries. One infant, 14 months old, had a hyperplasic left discending artery (LDA) draining in right ventricle cavity. Her ECG revealed signs of right ventricle overload. All the other cases had a typical angina syndrome with positive stress test. Left cineventriculography demonstrated left ventricle asynergy in 16 patients. We concluded that typical angina syndrome in our 22 patients, may be attributable to coronary anomalies observed at their coronary arteriograms.