Chikata Akio, Sakagami Satoru, Kanamori Naomi, Kato Chieko, Omi Wataru, Saeki Takahiro, Nagai Hideo, Usui Soichiro, Nakajima Kenichi, Takamura Masayuki
Department of Cardiology, National Hospital Organization, Kanazawa Medical Center, Japan.
Intern Med. 2015;54(17):2185-9. doi: 10.2169/internalmedicine.54.4333. Epub 2015 Sep 1.
A 75-year-old man with a 120-bpm tachycardia and typical atrial flutter was admitted. Echocardiography showed a dilated left ventricle with anterior and apical wall akinesia. Tachycardia was terminated with cavotricuspid isthmus ablation. Multiple imaging findings revealed a woven coronary artery anomaly (WCAA) in the left anterior descending artery. Stress myocardial perfusion imaging was performed after ablation in the sinus rhythm and revealed stress-induced ischemia and a fixed low uptake in the WCAA territory. WCAA is generally regarded as a benign condition; however, compromised blood flow within the anomaly, caused by tachycardia-related diastolic shortening, may induce ischemia.
