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Nonatheromatous Coronary Kink Causing Angiographic Obstruction: A Rare Structural Anomaly

Nikita Jhawar1, Abhiram Prasad2, S Michael Gharacholou3

  • 1Department of Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, USA.

Case Reports in Cardiology
|August 30, 2023
PubMed

Insights

Coronary kinking, a rare cause of exertional jaw pain, was diagnosed in a patient without typical risk factors. Advanced imaging and physiology confirmed the diagnosis and guided treatment for this unusual coronary anomaly.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Physiology

Background:

  • Ischemic symptoms can arise from various coronary artery pathologies.
  • Common causes include atherosclerosis, fibromuscular dysplasia, vasculitis, vasospasm, and microvascular disease.

Observation:

  • A patient presented with exertional jaw pain, a symptom of myocardial ischemia.
  • The patient lacked traditional atherosclerotic risk factors.

Findings:

  • Coronary kinking, an unusual anatomical variant, was identified as the cause of ischemia.
  • Multimodality and coronary imaging, alongside coronary physiology, were crucial for diagnosis.

Implications:

  • Coronary kinking should be considered in patients with ischemic symptoms, especially those without risk factors.
  • Accurate diagnosis using advanced imaging and physiology is key for effective management.

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