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A challenging case due to uncommon aberrancies

Mohammad Waleed1, Ali Raza2, Tariq Minhaj3

  • 1Department of Cardiology, Castle Hill Hospital, North Yorkshire, East Yorkshire, UK.

BMJ Case Reports
|September 26, 2015
PubMed

Insights

A 71-year-old man experienced exertional chest pain, leading to a coronary angiogram. Initial attempts were complicated by aberrant aortic anatomy, but further imaging clarified the vessels, enabling a successful procedure.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Diagnostic Imaging

Background:

  • Chest pain is a common symptom requiring prompt evaluation.
  • Coronary artery anatomy can present with variations, complicating interventional procedures.

Observation:

  • A 71-year-old male presented with exertional chest pain.
  • Initial coronary angiography was aborted due to guide wire ambiguity and suspected aberrant aortic anatomy.
  • Non-invasive imaging was crucial for delineating complex coronary and aortic anatomy.

Findings:

  • Successful coronary angiography and angioplasty were performed after re-planning.
  • The patient's complex vascular anatomy was successfully navigated.

Implications:

  • Accurate pre-procedural imaging is vital for managing complex coronary artery anatomy.
  • Interventional cardiology can overcome anatomical challenges with careful planning and advanced imaging.
  • This case highlights the importance of adapting diagnostic and interventional strategies to individual patient anatomy.

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