Alshoubi Abdalhai, Kurtz Brian, Dean Alan, Willey Adam, Keshishian Erika
Clinical Anesthesiology and Critical Care Medicine, St. Joseph's Medical Center, Stockton, USA.
Anesthesiology and Critical Care, St. Joseph's Medical Center, Stockton, USA.
Cureus. 2022 Jul 25;14(7):e27265. doi: 10.7759/cureus.27265. eCollection 2022 Jul.
Coronary artery anomalies are rare in the general population. Many individuals with coronary artery anomalies are asymptomatic. Some individuals with these anomalies have an increased risk of sudden cardiac death (SCD), especially young athletes, and an elevated risk of myocardial ischemia with anginal symptoms, seen in older age groups. We report a 43-year-old male who received coronary artery bypass graft (CABG) surgery for the four-vessel disease after suffering from an anteroseptal myocardial infarction (MI). The patient presented to the hospital emergency department with episodes of chest pain for three days. On coronary angiography, an anomalous origin of the left circumflex coronary artery (ALCx) was visualized. This ALCx was a type I variant originating from a separate ostium from the right coronary artery (RCA) at the right coronary cusp. It is important to document and describe the different variants of coronary anomalies to provide proper patient management. The anomalous origin of the left circumflex coronary artery from the right coronary cusp of the RCA is considered a benign variant. It may, however, have been instrumental in supplying blood to the left heart in the setting of complete left coronary artery (LCA) occlusion.
冠状动脉异常在普通人群中较为罕见。许多患有冠状动脉异常的个体没有症状。一些患有这些异常的个体发生心源性猝死（SCD）的风险增加，尤其是年轻运动员，而在老年人群中，出现心肌缺血伴心绞痛症状的风险也会升高。我们报告一名43岁男性，在发生前间隔心肌梗死（MI）后因四支血管病变接受了冠状动脉旁路移植术（CABG）。该患者因胸痛发作三天就诊于医院急诊科。冠状动脉造影显示左旋支冠状动脉（ALCx）起源异常。这条ALCx是I型变异，起源于右冠状动脉窦处与右冠状动脉（RCA）不同的开口。记录和描述冠状动脉异常的不同变异对于提供恰当的患者管理很重要。左旋支冠状动脉起源于RCA的右冠状动脉窦被认为是一种良性变异。然而，在左冠状动脉（LCA）完全闭塞的情况下，它可能对左心供血起到了作用。
