Presentation
Present On Admission POA Help "Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery [icd10data.com]
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]
Most symptomatic patients present at a young age. The coronary artery may pass between the aorta and the main pulmonary artery, representing a so-called interarterial course. [radiopaedia.org]
In the present case the right and left coronary arteries originated from the left posterior aortic sinus as a rare variation. [pulsus.com]
The reconstructed pulmonary artery (PA) does not present any narrowing. [jove.com]
Cardiovascular
-
Heart Block
[…] malformation of aortic and mitral valves, unspecified Q24 Other congenital malformations of heart Q24.2 Cor triatriatum Q24.3 Pulmonary infundibular stenosis Q24.4 Congenital subaortic stenosis Q24.5 Malformation of coronary vessels Q24.6 Congenital heart [icd10data.com]
Workup
Axis
-
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]
Treatment
[…] and prognosis Treatment of anomalous coronary arteries is controversial. [radiopaedia.org]
Evaluation of Vulnerable Atherosclerotic Plaques 409 Medical Treatment of Stable Angina 421 Medical Treatment of Unstable Angina and Acute NonSTElevation Myocardial Infarction 461 Treatment of Acute STElevation Myocardial Infarction 505 Medical Treatment [books.google.com]
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. Available from Further reading Pollock BD, Belkin RN, Lazar S, Pucillo A, Cohen MB, Weiss MB. [bjcardio.co.uk]
Treatment Options of symptomatic • Medical treatment/observation • Coronary angioplasty with stent deployment • Surgical repair 24. Thanks [slideshare.net]
If diagnosed antemortem, surgery is the treatment of choice in most cases Takeuchi procedure: used to correct the infantile form of anomalous origin of coronaries by creating a communication between the aorta and the left coronary ostium through the [pathologyoutlines.com]
Prognosis
[…] opposite sinus 4,5 : malignant course interarterial (i.e. between the aorta and the pulmonary artery): this is the most dangerous as it carries a high risk of sudden cardiac death benign course retroaortic prepulmonic septal (subpulmonic) Treatment and prognosis [radiopaedia.org]
Due to the severity of this patient’s anomaly, the best surgical decision, with the best prognosis, is CABG. [cathlabdigest.com]
Coronary bypass surgery does not carry a higher mortality, and further longitudinal studies will be required to determine the influence on long-term prognosis. Fig. 1. [kjim.org]
PMID: 16118540 See all (1) Prognosis Cardiovascular magnetic resonance of anomalous coronary arteries. Varghese A, Keegan J, Pennell DJ Coron Artery Dis 2005 Sep;16(6):355-64. [ncbi.nlm.nih.gov]
This affects the treatment and prognosis of the underlying disease. 7,11 The real incidence of CCAAs in the general population remains unclear, ranging from 0.2% to 5.6%. [revportcardiol.org]
Etiology
[…] pressure by maintaining PVR and myocardial contractility. 3 A ductus arteriosus maintained with prostaglandin may be the only supply of oxygenated blood to the coronaries. 1 The baby depicted in these images had elevated pulmonary pressures of unclear etiology [anesthesiology.pubs.asahq.org]
Clefts have a complex etiology and likely result from an interaction between environmental and genetic factors as well [ 43 ]. [omicsonline.org]
Isolated left coronary ostial stenosis is a rare condition of unknown etiology. [kjim.org]
Information Search database Search term Limits Advanced Help Full Report Format Full Report Summary (Text) Summary (XML) Send to: Choose Destination File Clipboard Collections MedGen UID: 833385 • Concept ID: CN229303 • Finding Orphanet: ORPHA99089 Etiology [ncbi.nlm.nih.gov]
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]
Epidemiology
"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]
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]
Hypoplastic coronary arteries have small luminal diameter (usually Epidemiology Frequency United StatesCoronary artery anomalies are observed in 0.3-1.3% of patients undergoing diagnostic coronary angiography, in approximately 1% of routine autopsy examinations [thehealthscience.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]
Epidemiologic studies suggest that genetic factors are the predominant cause of congenital heart disease (CHD) although environmental exposures are also relevant. [omicsonline.org]
Pathophysiology
Techniques 253 Clinical Cardiac Positron Emission Tomography 263 Magnetic Resonance Imaging of the Myocardium Coronary Arteries and Anomalous Origin of Coronary Arteries 283 Computed Tomograph Cardiovascular Imaging 338 Coronary Heart Disease Syndromes Pathophysiology [books.google.com]
[…] 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. 3. Michael H. Congenital anomalies of the coronary arteries. Heart 2005; 91 :1240–5. 4. Dollar AL, Roberts WC. [bjcardio.co.uk]
Pathophysiology Advances in imaging have improved detection and classification of this heterogeneous group of disorders. [www2.ccasociety.org]
This diverse group of congenital disorders is likely to show a broad variability of clinical manifestations as well as pathophysiological mechanisms of disease [ 1 – 3 ]. [bmccardiovascdisord.biomedcentral.com]
Prevention
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]
Coronary Artery Disease 657 Coronary Artery Bypass Surgery and Percutaneous Coronary Revascularization Impact on Morbidity and Mortality in Patients with Coronary Artery ... 683 Cardiovascular Genetics Focus on Genetics of Coronary Artery Disease 727 Preventive [books.google.com]
Preventing heart disease is the key. Doctors are also studying innovative ways to treat heart disease, including: Angiogenesis. [webmd.com]
These coronary anomalies can be detected in early stages of life, by developing the markers for identification and simultaneous surgery for the anomaly may be the best way to prevent sudden death [ 11 ]. References Datta AK. [pulsus.com]
Surgical repair of the coronary anomaly may be considered as the best way to prevent a future fatal cardiac event. Correspondence to Gavrielatos Gerasimos, M.D. [ispub.com]