Patent ductus arteriosus associated with congenital anomaly of coronary artery

Area of Science:

• Cardiology
• Congenital Heart Disease
• Cardiac Surgery

Background:

• Patent ductus arteriosus (PDA) is a common congenital heart defect.
• Congenital anomalies of the coronary arteries, such as anomalous origin, can present with varied clinical manifestations.
• The coexistence of PDA and coronary anomalies requires careful diagnostic evaluation.

Observation:

• A 21-year-old male presented with a cardiac murmur, palpitations, and atypical chest pain.
• Physical examination revealed a continuous murmur.
• Transthoracic echocardiography demonstrated a PDA with dilated pulmonary arteries and normal ventricular function, alongside an abnormal origin of both right and left coronary arteries from a single ostium.

Findings:

• The patient had a patent ductus arteriosus (PDA) combined with a rare congenital anomaly: the abnormal origin of both the right coronary artery (RCA) and left coronary artery (LCA) from a single ostium in the right coronary sinus.
• Despite the coronary anomaly, there was evidence of normal coronary flow and no clinical signs of myocardial ischemia.
• Surgical closure of the PDA was performed successfully.

Implications:

• This case highlights the importance of comprehensive cardiac evaluation in patients presenting with PDA, especially when accompanied by atypical symptoms.
• The successful surgical management of PDA in the presence of coronary anomalies underscores the feasibility of intervention even in complex congenital heart disease.
• Further research into the long-term outcomes and management strategies for combined PDA and coronary artery anomalies is warranted.