Heart failure in an elderly man: where is that coronary?
Charlie J Sang1, Stephen A Clarkson2, Elizabeth A Jackson2
1Internal Medicine - Pediatrics Residency Program, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Cardiology in the Young
|January 28, 2021
Summary
An unusual coronary artery defect originating from the pulmonary artery can cause heart failure in adults. This case highlights its complex pathophysiology and management with guideline-directed medical therapy.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Adult Cardiology
Background:
- Anomalous coronary arteries originating from the pulmonary artery (ACAPA) are rare congenital heart anomalies.
- These anomalies can lead to significant cardiovascular complications, including heart failure, particularly in the adult population.
Observation:
- This case report details an adult patient presenting with heart failure due to an anomalous right coronary artery originating from the pulmonary artery.
- The presentation was unusual, underscoring the varied clinical manifestations of ACAPA.
Findings:
- The study discusses the intricate pathophysiology underlying heart failure in patients with ACAPA.
- It emphasizes the importance of understanding the hemodynamic consequences of this anomaly.
Implications:
- Guideline-directed medical therapy plays a crucial role in managing patients with ACAPA and associated heart failure.
- This case contributes to the understanding and clinical management of rare coronary artery anomalies.
Related Concept Videos
01:17Pathophysiology of Heart Failure
2.2K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
2.2K
01:27Heart Failure I: Introduction
262
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
262
01:29Heart Failure II: Pathophysiology
224
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
224
01:30Heart Failure IV: Classification and Diagnostic Evaluation
135
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
135
01:21Coronary Circulation
5.6K
The heart, an organ critical to survival, gets nourishment not from the blood it pumps but from a separate circulation system known as coronary circulation. This is the shortest circulation in the body and is responsible for supplying the heart with the nutrients it needs to function effectively.
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
5.6K
01:26Imbalances in Cardiac Output
1.9K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.9K