Variant origin of the right coronary artery from the left main coronary artery together with aortic valve stenosis: report of a rare case / Origen variante de la arteria coronaria derecha a partir de la arteria coronaria izquierda junto con estenosis de la valva aórtica: reporte de un caso raro

SUMMARY: Variations in the origin of the right coronary artery have an incidence between 0.09 % and 0.92 %. Herein, we report a rare case of a coronary artery anomaly in which the right coronary artery originates from the left main coronary artery. This variant was found during routine coronarography, combined with an artificial aortic valve. Despite their rare occurrence, some variations in the origins of the coronary arteries can be life threatening and are associated with a higher risk of sudden cardiac death. They can also pose serious technical challenges and predispose to complications during coronary angiographic procedures. Thus, knowledge of such anomalies is paramount for managing the patients correctly.

Las variaciones en el origen de la arteria coronaria derecha tienen una incidencia entre el 0,09 % y el 0,92 %. En este documento, informamos un caso raro de una anomalía de la arteria coronaria en la que la arteria coronaria derecha se originaba en la arteria coronaria izquierda. Esta variante se encontró durante una coronariografía de rutina, combinada con una válvula aórtica artificial. A pesar de su rara aparición, algunas variaciones en los orígenes de las arterias coronarias pueden poner en peligro la vida y se asocian con un mayor riesgo de muerte súbita cardíaca. También pueden plantear serios desafíos técnicos y predisponer a complicaciones durante los procedimientos angiográficos coronarios. Por tanto, el conocimiento de dichas anomalías es fundamental para el manejo correcto de los pacientes.

Clinical study on transesophageal electrocardiogram for measuring left atrioventricular interval in patients with coronary artery disease / 重庆医学

Objective To explore the mechanism and clinical significance of left atrioventricular interval abnormality in the patients with coronary artery disease.Methods A total of 48 patients with coronary artery disease were selected and divided into the left interval atrioventricular shortening group(AV≤100 ms) and the left atrioventricular interval normal group(AR＞100 ms) according to the left atrioventricular interval measured by the esophageal electrocardiogram.The clinical features,cardiac echocardiography and coronary vessel lesions were compared between the two groups.Results The age in the AR≤ 100 ms group was higher than that in the AR＞10 ms group(P=0.018);the proportion of right coronary arterial lesion in the AR ≤ 100 ms group was higher in that in the AR＞10ms group(P=0.038);the left atrial diameter in the AR ≤100ms group was enlarged compared with that in the AR＞ 100 ms group(P=0.041).Conclusion The cardiac electric transduction abnormality exists in the patients with coronary heart disease,the majority of the patients with left atrioventricular interval shortening have the right coronary artery lesion.

Evaluation of cardiac magnetic resonance in 25 suspected coronary heart disease patients with ;abnormal electrocardiogram findings but normal coronary angiography / 中国介入心脏病学杂志

Objective To evaluate the diagnostic value of cardiac magnetic resonance (CMR) in suspected coronary heart disease patients with electrocardiogram abnormalities but normal coronary angiography. Methods The data of 25 suspected coronary heart disease patients with electrocardiogram abnormalities but normal coronary angiography were collected from Taiyuan central hospital between October 2010 and April 2012. Comparison was done in terms of anterior interventricular septal thickness, left ventricular posterior wall thickness, left ventricular end diastolic dimension, left ventricular end systolic dimension, left atrial diameterand ejection fraction measured by CMR and by UCG. Correlation of the aboved paremeters between the 2 imaging exams. Results 40%of patients had their diagnosis changed after CMR exam, 32%of the patients with adjusted assessment. The differences in anterior interventricular septal thickness, left ventricular posterior wall thickness, left ventricular enddiastolic dimension, left ventricular end systolic dimension, left atrial diameter, ejection fraction by CMR and by UCG were similar (P>0.05) with positive correlation (P<0.01). Conclusions CMR can provide diagnosis and evaluation information to chest pain patients with ECG abnormalities but normal CAG, and it is a good supplement for routine examination.