Barbiero Giulio, Maiolino Giuseppe, Argiolas Anna, Testolin Luca, De Conti Giorgio
Department of Integrated Diagnostic Services, DIDAS, Radiology Unit, University Hospital of Padua, Padua 35128, Italy.
Department of Medicine, Medical Clinic 3, University Hospital of Padua, Padua 35128, Italy.
World J Cardiol. 2022 Sep 26;14(9):514-521. doi: 10.4330/wjc.v14.i9.514.
Intra-atrial right coronary artery (RCA) is a rare and generally asymptomatic anomaly of development of the coronary arteries. This malformation could potentially expose the patient to a catastrophic outcome in the case of injury during interventional or surgical procedures. Currently, only a few case reports and no systematic reviews are available in the literature.
We report the case of a 54-year-old man with atypical chest pain who underwent multi-detector computed tomography angiography (MDCTA). The exam revealed no significant coronary artery stenoses; however, an intra-atrial course of mid RCA was evident. Medical therapy was administered, and the patient was discharged to home without undergoing a conventional angiography. Previously reported autoptic and clinical cases were retrieved from the PubMed literature database to compare the clinicopathological features of this case.
MDCTA depicted the abnormal course of the coronary artery in this patient as an intra-atrial course of the mid RCA. Finding this abnormality was crucial to avoid an inadvertent injury during interventional or surgical procedures.
心房内右冠状动脉(RCA)是一种罕见的、通常无症状的冠状动脉发育异常。在介入或外科手术过程中,如果发生损伤,这种畸形可能会使患者面临灾难性后果。目前,文献中仅有少数病例报告,尚无系统评价。
我们报告一例54岁非典型胸痛男性患者,其接受了多排螺旋CT血管造影(MDCTA)检查。检查显示无明显冠状动脉狭窄;然而,RCA中段心房内走行明显。给予药物治疗,患者未行传统血管造影即出院回家。从PubMed文献数据库检索先前报道的尸检和临床病例,以比较该病例的临床病理特征。
MDCTA显示该患者冠状动脉异常走行为RCA中段心房内走行。发现这一异常对于避免介入或外科手术过程中的意外损伤至关重要。