Assuntos
Angioplastia Coronária com Balão , Anomalias dos Vasos Coronários/complicações , Infarto do Miocárdio/terapia , Seio Aórtico/anormalidades , Angiografia Coronária , Anomalias dos Vasos Coronários/diagnóstico , Eletrocardiografia , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/diagnóstico , Seio Aórtico/diagnóstico por imagem , Resultado do TratamentoRESUMO
A 65-year-old man with stable angina refractory to medical therapy and with a low-threshold myocardial ischemia at ECG stress testing was referred for coronary angiography. The coronary angiogram showed an ostial subocclusive stenosis of a developed first diagonal branch located just upstream of a subocclusive stenosis of the mid left anterior descending (LAD) coronary artery, occluded distally, and a coronary collateral for LAD from a developed right ventricular branch arising with separate ostia from the right sinus of Valsalva. We discuss the diagnostic interpretation of this coronary anomaly and some aspects regarding the percutaneous treatment of bifurcations.
Assuntos
Circulação Colateral , Circulação Coronária , Estenose Coronária/complicações , Anomalias dos Vasos Coronários/complicações , Idoso , Angiografia Coronária , Estenose Coronária/diagnóstico por imagem , Anomalias dos Vasos Coronários/diagnóstico por imagem , Humanos , MasculinoRESUMO
Anomalies of the coronary artery are incidentally detected during coronary angiography and are seldom found in daily clinical practice. In the reported studies, the incidence ranges from 0.6 to 1.3%, and men are more frequently affected. Among the different types, the detection of a double left anterior descending coronary artery emerging from the right coronary sinus is extremely rare. We describe a case of a 64-year-old male patient admitted to our institution because of ST segment elevation myocardial infarction. After successful systemic lysis, he underwent coronary angiography that showed multivessel coronary disease, a patent infarct-related artery and a double left anterior descending artery. We discuss the clinical relevance of a coronary artery emerging from the opposite Valsalva sinus and its clinical implications.
