Images in Clinical Medicine Samuel Wann, M.D., and Gregory Schuchard, M.D. 4 Citing Articles A 49-year-old man presented for evaluation of palpitations and epigastric and burning pain in the lower chest. [nejm.org]

Case presentation A 53-year-old woman, previously fit and well, presented with a history of exertional chest discomfort radiating to left breast and left arm, with risk factors for coronary artery disease (hypertension and smoking). Figure 2. [bjcardio.co.uk]

Clinical Presentation Patients with ALCAPA usually present with symptoms early within the first year of life with chronic ischemia due to this coronary artery malformation leading to congestive heart failure. [omicsonline.org]

Here we would like to attract attention to coronary abnormalies by presenting this case. [openaccessjournals.com]

The reconstructed pulmonary artery (PA) does not present any narrowing. [jove.com]

• Pulmonary Valve Stenosis

  valves stenosis insufficiency absence tricuspid valves stenosis atresia Ebstein's anomaly Hypoplastic right heart syndrome Uhl anomaly Left aortic valves stenosis insufficiency bicuspid mitral valves stenosis regurgitation Hypoplastic left heart syndrome [en.wikipedia.org]

• Heart Disease

  I will touch on coronary artery sequelae attributed to antecedent Kawasaki disease observed in adult ischaemic heart disease, as well as the recent topic of coronary circulation in adults with cyanotic congenital heart disease (CCHD). [radcliffecardiology.com]

  […] of Adults With Congenital Heart Disease). [wikidoc.org]

  Discussion Heart disease persists as the leading cause of death in the US as per the Centers for Disease Control and World Health Organization [ 1 ]. [omicsonline.org]

  Author information 1 Department of Pediatric Cardiology and Adults with Congenital Heart Disease, Meyer Children's Hospital, Rambam Health Care Campus, Box 9602, 31096, Haifa, Israel. [ncbi.nlm.nih.gov]

  […] title=Coronary_artery_anomaly&oldid=886960574 " Categories : Heart diseases Circulatory disease stubs Hidden categories: All stub articles [en.wikipedia.org]

• Tachycardia

  The occurrence of a supraventricular tachycardia must be addressed with antiarrhythmics or cardioversion in a timely manner. [www2.ccasociety.org]

  […] or following exercise can sometimes compress the coronary artery enough to diminish blood flow to the myocardium, which can cause re-entry phenomenon in the myocardium and sudden cardiac death due to ventricular fibrillation or sustained ventricular tachycardia [radiopaedia.org]

  Then Electrophysiological study showed non sustained ventricular tachycardia .Decision was taken to proceed for left heart catheterization to diagnose if there was underlying ischemia. Unexpected finding at this age was proved. [oatext.com]

  Infants with ALCAPA typically have feeding difficulties, irritability, diaphoresis, tachypnea and tachycardia. Associated chest pain can occasionally be due to myocardial ischemia which may be confused with infantile colic. [omicsonline.org]

  […] bridging reported on CT (26%) compared to conventional angiography (0.5% to 4.5%). 13 Though myocardial bridging can be seen as a normal variant, without being clinically overt in a large proportion of cases, it has been infrequently linked with ischemia, tachycardia-induced [appliedradiology.com]

• Continuous Murmur

  In 2, aged 6 and 7 years, the anomaly was of the adult type; the patients were free from symptoms but had continuous murmurs at the left sternal border and mild left ventricular hypertrophy. [jamanetwork.com]

  If a continuous murmur is present, its origin should be defined either by echocardiography, MRI, CT angiography, or cardiac catheterization. ( Level of Evidence: C ) " ” 2. [wikidoc.org]

  A continuous murmur resembling a patent ductus arteriosus with flow from the aorta to the pulmonary circulation can be found reflecting collateral flow. [omicsonline.org]

• Heart Murmur

  During an exam, the health care provider will likely find signs of ALCAPA, including: Abnormal heart rhythm Enlarged heart Heart murmur (rare) Rapid pulse Tests that may be ordered include: Echocardiogram, which is an ultrasound that views the heart structures [medlineplus.gov]

  Often a heart murmur is present. The electrocardiogram is usually abnormal. On chest x-ray, the heart is usually quite enlarged. The definitive diagnosis is usually made by an echocardiogram. [mottchildren.org]

• Systolic Murmur

  Case report A healthy, athletic, 25-year-old black man was referred to our institution for evaluation of a short systolic murmur. [mdmag.com]

When ACAOS is identified in this manner, a further workup should include nuclear stress testing. [circ.ahajournals.org]

• Left Axis Deviation

  His electrocardiogram revealed normal sinus rhythm at a rate of 80 beats/min, left axis deviation, left atrial abnormality, and T-wave inversion in lead V 6. [read.nxtbook.com]

• T Wave Inversion

  The resting electrocardiogram demonstrated incomplete right bundle branch block and T wave inversion in the inferior leads. Transthoracic echocardiography revealed no wall motion abnormalities with a normal ejection fraction. [ispub.com]

  His electrocardiogram revealed normal sinus rhythm at a rate of 80 beats/min, left axis deviation, left atrial abnormality, and T-wave inversion in lead V 6. [read.nxtbook.com]

• Ventricular Hypertrophy

  In 2, aged 6 and 7 years, the anomaly was of the adult type; the patients were free from symptoms but had continuous murmurs at the left sternal border and mild left ventricular hypertrophy. [jamanetwork.com]

  The initial ECG illustrated left ventricular hypertrophy with ST-T wave changes compatible with repolarization abnormality (Figure 1). The Troponin I was elevated at 0.17. [scmr.org]

  Causes of death were severe atherosclerosis (nine), hypertrophic cardiomyopathy with asymmetry (eight), coronary artery anomalies (four), idiopathic concentric left ventricular hypertrophy (three), myocarditis (two), arrhythmogenic right ventricle (one [researchgate.net]

Treatment recommendations from medical experts may vary because there is not yet an agreed-upon “correct” way to treat AAOCA. [chop.edu]

Treatment for ACA may include: Medical treatment. Various methods of medical treatment for ACA may include: Medications to strengthen the heart, affect the blood pressure, and/or remove extra fluid from the body (water pills). [stanfordchildrens.org]

Surgical treatment of coronary artery anomalies: report of a 37 ½-year experience at the Texas Heart Institute. Tex Heart Inst J 2002; 29 :299–307. [bjcardio.co.uk]

Treatment Prior to treatment, assessment of myocardial ischemia is identified by exercise treadmill, 201TI SPECT, or dobutamine stress echocardiography [ 20 ]. [omicsonline.org]

Treatment Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is and what type of ACA your child has. Treatment for an ACA may include: Medicines. [stlouischildrens.org]

The deadliest of pathways, with the worst prognosis, is the inter-arterial course. This is when the LCA makes its course between the aortic root and right ventricular outflow tract (RVOT). [pubs.sciepub.com]

Only such efforts can give rise to the large-scale studies needed to define the prognosis and optimal treatment of individual forms of CAAs. [circ.ahajournals.org]

The authors concluded that the prognosis of middle-aged to elderly patients with an anomalous origin of the coronary artery is relatively good. [journals.lww.com]

Zheng JY, Han L, Ding WH, Jin M, Zhang GZ, et al. (2010) Clinical features and long-term prognosis of patients with anomalous origin of the left coronary artery from the pulmonary artery. Chin Med J (Engl) 123: 2888-2894. [omicsonline.org]

The prognosis of patients with this anomaly after coronary artery repair during adulthood is excellent. 5 Coronary Artery Sequelae Attributed to Antecedent Kawasaki Disease Observed in Adult Ischaemic Heart Disease As paediatricians were not commonly [radcliffecardiology.com]

Because acquired etiologic factors were not detected, we believe that the lesions were structural defects of congenital origin. [ncbi.nlm.nih.gov]

Etiology Theories have been described to explain the origin of a coronary artery from the pulmonary trunk specifically related to the embryologic division of the truncus arteriosus. [omicsonline.org]

These anomalies have different clinical and anatomical presentations that still need more studies to know the prevalence, etiology or risk factors and how to screen for such anomalies. [oatext.com]

The prevalence is reported to be 0.002%. 10 Various etiologies are known; they include traumatic, infectious, and iatrogenic causes. The involved fistulous artery is often dilated and tortuous. [appliedradiology.com]

Finocchiaro G, Papadakis M, Robertus JL, et al Etiology of sudden death in sports. Insights from a United Kingdom Regional Registry. JACC 2015;67:2108–15. [14]. [journals.lww.com]

"rarely" encountered in the general population Epidemiology Coronary anomalies affect 1% of the general population Necropsies yield an even lower incidence (0.3%) According to the Sudden Death Committee of the American Heart Association, coronary anomalies [pathologyoutlines.com]

Chugh SS, Reinier K, Teodorescu C, Evanado A, Kehr E, et al. (2008) Epidemiology of sudden cardiac death: clinical and research implications. ProgCardiovasc Dis 51: 213-228. [omicsonline.org]

Kardos A, Babai L, Rudas L et al: Epidemiology of congenital coronary artery anomalies: a coronary arteriography study on a central European population. Cathet Cardiovasc Diagn. 1997 Nov;42(3): 270-275. 7. [ispub.com]

Epidemiology of congenital coronary artery anomalies: a coronary arteriography study on a central European population. Cathet Cardiovasc Diagn. 1997;42:270-275. Lipton MJ, Barry WH, Obrez I, et al. [read.nxtbook.com]

[…] ramifications as well as fistulas from the RCA, LCA, or infundibular artery to the following: Right ventricle Right atrium Coronary sinus Superior vena cava Pulmonary artery Pulmonary vein Left atrium Left ventricle Multiple, right and left ventricles Epidemiology [emedicine.medscape.com]

Letture consigliate Cademartiri F, Runza G, Luccichenti G et al (2006) Coronary artery anomalies: incidence, pathophysiology, clinical relevance and role of diagnostic imaging. [link.springer.com]

Anomalous coronary artery arising from the opposite sinus: descriptive features and pathophysiologic mechanisms, as documented by intravascular ultrasonography. J Invasive Cardiol. 2003 Sep;15(9):507-14. (26.) [aprendeenlinea.udea.edu.co]

[…] of deaths in athletes ( Circulation 1996;94:850 ) Burke et. al. reported that in 14 to 40 year olds, coronary anomalies are involved in 12% of sports related sudden cardiac deaths versus 1.2% of non sports related deaths ( Am Heart J 1991;121:568 ) Pathophysiology [pathologyoutlines.com]

Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation 2002; 105 :2449–54. http://dx.doi.org/10.1161/01.CIR.0000016175.49835.57 3. Michael H. Congenital anomalies of the coronary arteries. [bjcardio.co.uk]

Pathophysiological Mechanisms and Coronary Anomalies (Functional Classification) Pathophysiological Mechanism Coronary Anomaly Proof of Action Certain Possible Unlikely ALCAPA indicates anomalous origination of the left coronary artery from the pulmonary [circ.ahajournals.org]

We wish we could have done something to prevent it, especially when it happens in our hometown. While hypertrophic cardiomyopathy is the leading cause of SCA in teens, there is a second-leading cause, which is not as well known. [blog.cincinnatichildrens.org]

Children’s heart conditions can’t be prevented, but a lot can be done to improve and often completely repair their hearts at any age. [nemours.org]

Medicines For patients with mild to moderate symptoms, medicines may be used, especially to prevent sudden cardiac death. Diuretics (water pills) reduce excess fluid in the body, relieving the stress on the heart’s pumping action. [texasheart.org]

Antibiotics are sometimes prescribed to prevent SBE. Your pediatric cardiologist will tell you whether your child needs this protection, which is often referred to as SBE prophylaxis, before and after dental or surgical procedures. [mottchildren.org]

Your child’s healthcare provider will give him or her medicine to help relax and prevent pain (sedation). Your child’s blood pressure and oxygen levels will be checked during the test. [stlouischildrens.org]