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Unusual intercoronary communication of possible traumatic origin: a case report

Gal Sella1, Sharon L Kracoff2

  • 1Department of Cardiology, Kaplan Medical Center, Pasternak St. POB 1, Rehovot, Israel.

European Heart Journal. Case Reports
|April 26, 2019
PubMed

Insights

A rare coronary artery anomaly, an unusual intercoronary communication, was observed in a patient without obstructive coronary artery disease. This finding suggests a potential traumatic origin rather than a congenital cause, requiring no intervention.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Anatomical Variations

Background:

  • Coronary arteries possess small, normally insignificant anastomoses.
  • Significant coronary stenosis can enlarge these anastomoses, making them visible.
  • Large intercoronary communications without obstructive disease are rare anomalies, typically considered congenital.

Observation:

  • A 62-year-old man presented with angina and underwent coronary angiography.
  • Angiography revealed severe circumflex artery stenosis and an unusual intercoronary communication between the left main and left anterior descending arteries.
  • A history of adolescent chest trauma was noted; the communication was present on a prior angiogram and unchanged.

Findings:

  • The patient's symptoms resolved after stenting the circumflex artery.
  • The intercoronary communication, unusual in location and morphology, was noted.
  • The anomaly's presence over 4 years without change was documented.

Implications:

  • Intercoronary communications in atypical locations may result from trauma, not solely congenital factors.
  • This specific type of coronary artery anomaly does not necessitate interventional treatment.
  • Understanding the etiology of coronary artery anomalies aids in appropriate clinical management.
Abstract

Keywords:
AngiogenesisCase reportChest traumaCoronary anomaly

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