RESUMO
The coronary anomalies are rarely seen in clinical practice. A 47-year-old female patient presented to hospital with chest pain on exertion. The coronary angiography and cardiac tomography showed the anomalous origin of the left main from the right coronary artery.
RESUMO
OBJECTIVE: This study aimed to assess the incidence of coronary anomalies using 64-multi-slice coronary computed tomography (MSCT). METHODS: The diagnostic MSCT scans of 745 consecutive patients were reviewed. RESULTS: The incidence of coronary anomalies was 4.96%. The detected coronary anomalies included the conus artery originating separately from the right coronary sinus (RCS) (n = 8, 1.07%), absence of the left main artery (n = 7, 0.93%), a superior right coronary artery (RCA) (n = 7, 0.93%), the circumflex artery (CFX) arising from the RCS (n = 4, 0.53%), the CFX originating from the RCA (n = 2, 0.26%), a posterior RCA (n = 1, 0.13%), a coronary fistula from the left anterior descending artery and RCA to the pulmonary artery (n = 1, 0.13%), and a coronary aneurysm (n = 1, 0.13%). CONCLUSIONS: This study indicated that MSCT can be used to detect common coronary anomalies, and shows it has the potential to aid cardiologists and cardiac surgeons by revealing the origin and course of the coronary vessels.
Assuntos
Angiografia Coronária/métodos , Anomalias dos Vasos Coronários/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Adulto , Idoso , Anomalias dos Vasos Coronários/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Ponte Miocárdica/diagnóstico por imagem , Ponte Miocárdica/epidemiologia , Valor Preditivo dos Testes , Estudos Retrospectivos , Turquia/epidemiologiaRESUMO
Coeliac artery aneurysms are rare and frequently detected incidentally. It is usually with associated aneurysms. Herein we present accidentally detected, asymptomatic coeliac aneurysm in a patient with acute myocardial infarction. Multi-slice tomography and invasive angiography images are provided along with brief discussion on clinical presentation, diagnostic tools and treatment options.
Assuntos
Aneurisma , Artéria Celíaca , Aneurisma/complicações , Aneurisma/diagnóstico por imagem , Artéria Celíaca/diagnóstico por imagem , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/diagnóstico , RadiografiaRESUMO
Spontaneous left main coronary artery (LMCA) dissection is an unusual cause of myocardial ischemia and sudden death. It is defined as an intramural hematoma of the media of the vessel wall. A 56-year-old male who underwent a two-vessel bypass ten years previous presented with chest pain for two hours. His blood pressure and heart rate were 60/35 mmHg and 120 beats per minute, respectively. The ECG showed inferior ST-segment elevation. Coronary angiography revealed total LMCA occlusion with dissection flap. A dissection flap was collapsing the true lumen of the LMCA. A bare metal stent was implanted after the flap was perforated and fenestrated by a stiff guide wire. Good TIMI 3 flow was achieved in the circumflex artery. Three months after the index procedure, coronary computed tomography angiography disclosed thrombosis of the false lumen beneath the patent left main stent. In conclusion, primer stenting can be successfully performed in the presence of spontaneous LMCA dissection.
