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Angina pain associated with isolated R-IIP modified Lipton classification coronary artery anomaly

Nicholas Coffey1, Alexis Smith2, Rich Pham3

  • 1Medical Student University of Kentucky College of Medicine - Bowling Green Campus, 399 US 31 W Bypass Bowling Green, KY 42101, USA.

The British Journal of Cardiology
|October 10, 2022
PubMed

Insights

A rare coronary artery anomaly, R-IIP modified Lipton classification, was found in a patient with typical angina pain and coronary artery disease risk factors. This finding explains the patient's symptoms despite the absence of atherosclerosis.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Coronary artery disease (CAD) is a leading cause of angina.
  • Coronary artery anomalies are rare but can mimic CAD symptoms.
  • Risk factors for CAD include hypertension, hyperlipidemia, and smoking.

Purpose of the Study:

  • To report a case of a patient presenting with angina and CAD risk factors.
  • To describe the diagnosis and characteristics of an isolated R-IIP modified Lipton classification coronary artery anomaly.
  • To discuss the potential link between this anomaly and angina symptoms in the absence of atherosclerosis.

Main Methods:

  • Case report of a patient with typical angina.
  • Cardiac catheterisation to investigate coronary arteries.
  • Coronary computed tomography angiography (CCTA) for confirmation and detailed imaging.
  • Review of relevant literature on coronary artery anomalies and atherosclerosis.

Main Results:

  • Diagnosis of an isolated R-IIP modified Lipton classification coronary artery anomaly.
  • Confirmation of the anomaly via CCTA.
  • Patient presented with prototypical angina pain.
  • No significant atherosclerosis was apparent on imaging.

Conclusions:

  • Coronary artery anomalies can present with symptoms mimicking obstructive CAD.
  • The R-IIP modified Lipton classification anomaly may predispose to atherosclerosis or cause ischemic symptoms through other mechanisms.
  • Further investigation is needed to understand the long-term implications and management of such anomalies.

Keywords:
cardiac catheterisationcomputed tomography (CT) angiographcongenital heart defect

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