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Inducible myocardial ischaemia and anomalous origin of the right coronary artery coursing between the aorta and pulmonary artery: a rare, sinister entity.
- Source :
-
BMJ case reports [BMJ Case Rep] 2012 Jul 04; Vol. 2012. Date of Electronic Publication: 2012 Jul 04. - Publication Year :
- 2012
-
Abstract
- The authors report the case of a 49-year-old man with episodes of chest discomfort. Exercise/rest single-photon emission tomography (SPECT) with technetium-99m sestamibi (MIBI) revealed inferior and septal myocardial ischaemia, and MIBI anterior reverse redistribution, representing damaged myocardium. Cardiac tomography documented anomalous origin of the right coronary artery (ARCA) arising from the left sinus of valsalva coursing between the aorta and pulmonary artery. Myocardial ischaemia and myocardial damage revealed by SPECT are related to the transient coronary flow reduction elicited by the compression of the ARCA that is produced by the great arteries during exercise. The ARCA is a rare condition, but may cause myocardial infarction and sudden death. β-blockers and dihydropyridine calcium-channel blockers may provide cardioprotection from inducible myocardial ischaemia. However, in case of failure of medical cardioprotection, relocation of the ARCA to the appropriate aortic sinus and coronary bypass grafting could be considered as the best options.
- Subjects :
- Adrenergic beta-Antagonists therapeutic use
Calcium Channel Blockers therapeutic use
Chest Pain etiology
Coronary Vessel Anomalies drug therapy
Exercise
Humans
Male
Middle Aged
Myocardial Ischemia drug therapy
Radiography
Tomography, Emission-Computed, Single-Photon
Coronary Vessel Anomalies complications
Coronary Vessel Anomalies diagnostic imaging
Myocardial Ischemia diagnostic imaging
Myocardial Ischemia etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1757-790X
- Volume :
- 2012
- Database :
- MEDLINE
- Journal :
- BMJ case reports
- Publication Type :
- Academic Journal
- Accession number :
- 22764157
- Full Text :
- https://doi.org/10.1136/bcr.02.2012.5884