Karikalan Suganya, Sharma Munish, Chandna Megha K, Chandna Harish, Surani Salim
Medicine, Karpaga Vinayaga Institute of Medical Sciences, Maduranthagam, IND.
Pulmonary Medicine, Pulmonary Asociates, Corpus Christi, USA.
Cureus. 2021 Oct 22;13(10):e18966. doi: 10.7759/cureus.18966. eCollection 2021 Oct.
Coronary artery anomalies are rare congenital malformations, most often undiagnosed until late adolescence or adulthood when an angiogram is done for conditions such as myocardial infarction, arrhythmias, heart failure, and sudden cardiac death. Sometimes, an anomalous left coronary artery originating from the right coronary ostium might traverse between the aorta and pulmonary artery and cause chest pain, syncope, myocardial infarction, or sudden death even in younger patients. Here we present a case of an elderly female presenting with chest discomfort on exertion. The coronary angiogram revealed severe triple vessel disease and an ectopic left anterior descending artery arising from the right coronary ostium. After careful evaluation, it was determined that her symptoms were solely due to severe multivessel coronary artery disease (CAD). Thus, she underwent coronary artery bypass surgery for her CAD. It is important to consider anomalous coronary artery as an important differential diagnosis in patients with angina, ventricular arrhythmias, or even sudden cardiac death, especially in the younger population.
冠状动脉异常是罕见的先天性畸形，通常在青春期后期或成年期进行血管造影检查心肌梗死、心律失常、心力衰竭和心源性猝死等疾病时才被诊断出来。有时，起源于右冠状动脉开口的异常左冠状动脉可能在主动脉和肺动脉之间穿行，甚至在年轻患者中也会导致胸痛、晕厥、心肌梗死或猝死。在此，我们报告一例老年女性患者，她在运动时出现胸部不适。冠状动脉造影显示严重的三支血管病变以及一条起源于右冠状动脉开口的异位左前降支动脉。经过仔细评估，确定她的症状完全是由严重的多支冠状动脉疾病（CAD）引起的。因此，她因CAD接受了冠状动脉搭桥手术。对于心绞痛、室性心律失常甚至心源性猝死患者，尤其是年轻人群，将异常冠状动脉作为重要的鉴别诊断是很重要的。
