High risk coronary artery anomalies in 5131 adult patients undergoing coronary arteriography at Nicvd Karachi

ABSTRACT

To evaluate the frequency, origin, course and clinical significance of coronary anomalies. Single centre, descriptive study. The study was carried out at National Institute of Cardiovascular Diseases, [NICVD] Karachi, from January 2003 to July 2004. All adult patients [n=5131] undergone during study period for coronary arteriography included. Coronary arteriograms were evaluated for coronary anomalies by author. Patients with low risk coronary anomalies were excluded from study. Seventy two percent were males and 28% females; the mean age of patients was 54 years with a range of 26 years to 70 years. Fifty five percent were present with chestpain,33.3% with shortness of breath and 11.1% with palpitation. Total frequency was seen in 0.35%; out of them 88.8% have anomalous origin and distribution while 11.11% have coronary artery fistula. Left circumflex, LAD, left main coronary artery arise from right sinus of valsalva with frequency of 0.155, 0.058 and 0.058% respectively. In 0.058% of patients RCA arise from left sinus while 0.038% patients LAD arise from non coronary sinus. Coronary fistula noted in 0.038% patients. Clinicians, cardiologists and cardiac surgeons may consider coronary anomalies to be interesting rarities. The proper recognition determine the proper course of action for their management