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
Summary
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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