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[Long-term clinical course in the anomalous origin of coronary arteries]
Insights
An abnormal origin of coronary arteries can be benign if isolated. However, when associated with other heart conditions, it leads to poor outcomes, including death and myocardial infarction.
Area of Science:
- Cardiology
- Congenital Heart Disease
Background:
- Abnormal origin of the coronary arteries (AOCA) is a congenital heart anomaly.
- The clinical significance of AOCA varies depending on whether it is isolated or associated with other cardiac conditions.
Purpose of the Study:
- To investigate the long-term clinical course and prognosis of adult patients diagnosed with anomalous origin of coronary arteries.
- To determine the impact of associated heart diseases on the outcomes of patients with AOCA.
Main Methods:
- Retrospective analysis of 15 adult patients with AOCA diagnosed from 5500 coronarographic examinations.
- Long-term follow-up through ambulatory examinations for an average of 64.6 months post-coronarography.
Main Results:
- Four patients had isolated AOCA with a favorable long-term course.
- Eleven patients had AOCA associated with other heart diseases (coronary disease, rheumatic heart disease, atrial septal defect).
- Patients with associated AOCA experienced unfavorable outcomes, including death, myocardial infarction, angina, and cardiac dysrhythmia.
Conclusions:
- Isolated anomalous origin of coronary arteries appears to be a relatively benign condition.
- The prognosis for patients with AOCA is primarily determined by the presence and type of associated heart disease.
Abstract:
The authors analyze in a retrospective investigation the clinical picture of 15 adult patients (12 men and 3 women) with an abnormal origin of the coronary arteries, diagnosed from a total of 5500 coronarographic examinations made in the Institute for Clinical and Experimental Medicine. In four patients the anomaly was isolated and in 11 patients it was associated: in six with coronary disease, in three with rheumatic heart disease and in two with an atrial septal detect. The authors evaluate the long-term clinical course by check-up ambulatory examinations after time intervals of 64.6 +/- 45.7 months following the coronarographic examination. The long-term course was favourable in the four patients with the isolated anomalous origin of the coronary arteries. In patients with an associated anomalous origin of the coronary arteries and other heart disease the long-term course was not favourable. Two patients died, two suffered a myocardial infarction, one suffered from angina and one from cardiac dysrhythmia. The authors assume that the complications developed mainly due to the associated heart disease, congenital or acquired. The objective physical finding, ECG and X-ray finding of the heart and lungs did not change significantly in the meantime. It appears thus that an isolated anomalous origin of the coronary arteries may be a relatively benign disease. The prognosis of the patients depends above all on associated heart disease or other diseases.