ABSTRACT
Coronary artery anomalies (CAAs) comprise a diverse group of congenital malformations with widely varying expressions and pathophysiological mechanisms. The most notable group of CAAs has been termed ‘Anomalous coronary artery originating from the opposite sinus of Valsalva’ (ACAOS), a rare congenital heart disease that is associated with sudden cardiac death and ischemia. We present the case of an 80-year-old man presenting with inferior STEMI having a single coronary ostium and a rare variant of the coronary artery origin belonging to type A4d with an interatrial LAD course according to Angelini's classification. This abnormal finding was managed conservatively and the patient underwent successful drug-eluding stent implantation in the culprit right coronary artery in its middle portion.
ABSTRACT
Glucogen storage diseases such as Andersen's disease are inherited disorders of carbohydrate metabolism. Cardiac involvement in Andersen's disease is extremely unusual and difficult to diagnose, especially in elderly individuals with atypical presentations. The following is a case of a 61-year-old man with a family history of muscle weakness who presented with congestive heart failure and was found to have Andersen disease cardiomyopathy. The diagnosis was made in view of the normal negative workup for cardiomyopathy, massive glucose tetrasaccharide excretion, and normal alpha-glucosidase activity. The patient rapidly deteriorated and passed away. This case highlights the need to consider storage diseases in adults with nonischemic dilated cardiomyopathy of uncertain etiology in the presence of liver or muscle involvement