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Unusual intercoronary communication of possible traumatic origin: a case report
1Department of Cardiology, Kaplan Medical Center, Pasternak St. POB 1, Rehovot, Israel.
European Heart Journal. Case Reports
|April 26, 2019
Summary
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.
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