1. Anomalous Origin of Left Anterior Descending Artery and Left Circumflex Artery from Right Coronary Sinus with Malignant Left Anterior Descending Artery Course: Role of Coronary CT Angiography Derived Fractional Flow Reserve in Decision Making
- Author
-
Sajjad Ahmad, Muhammad Umer Awan, Jason H. Cole, Bassam Omar, Joey Glass, and Hassan Tahir
- Subjects
medicine.medical_specialty ,Cardiology ,Fractional flow reserve ,030204 cardiovascular system & hematology ,sudden cardiac death ,Sudden cardiac death ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Internal medicine ,medicine ,030212 general & internal medicine ,Circumflex ,coronary ct angiogram fractional flow reserve ,Coronary sinus ,Aorta ,business.industry ,General Engineering ,coronary anomalies ,medicine.disease ,medicine.anatomical_structure ,Pulmonary artery ,business ,Artery - Abstract
Congenital coronary anomalies are uncommon and are mostly asymptomatic; however, patients may have symptoms depending on the origin and course of anomalous artery. Very rarely, coronary anomalies can also lead to life-threatening complications especially in young athletes. A malignant course of the left main (LM) or left anterior descending (LAD) artery between aorta and pulmonary artery is considered the most significant risk factor for such complications. Various noninvasive tests are available to evaluate myocardial ischemia due to anomalous coronary artery. Coronary computed tomography (CT) angiogram derived fractional flow reserve (CT-FFR) is a noninvasive diagnostic test which has shown promising results in the hemodynamic assessment of obstructive coronary artery disease. However, its role in coronary anomalies has not been studied. We present a case of a 22-year-old male who presented with atypical chest pain and was found to have anomalous origin of left anterior descending (LAD) artery and left circumflex (LCX) artery from right coronary sinus. LAD had a malignant course for which CT-FFR was done which was hemodynamically nonsignificant. The decision was made to manage the patient conservatively.
- Published
- 2018
- Full Text
- View/download PDF