Olson Peter C, Cinelli Michael, Rahming Hamfreth S, Assaad Marc, Spagnola Jonathan, Lafferty James C
Cardiovascular Imaging Program, Yale School of Medicine, New Haven, CT, USA.
Department of Cardiology, Staten Island University Hospital - Northwell Health, Staten Island, NY, USA.
J Med Cases. 2022 Oct;13(10):491-494. doi: 10.14740/jmc3986. Epub 2022 Oct 31.
Coronary artery anomalies (CAAs) are known to be anatomical aberrations in the origin and structure. Due to the diverse anatomical variants, surgeons and angiographers have struggled when faced with patients who have CAA. To frame the complicated issues surrounding CAA, we present a case of a young patient found to have two CAAs, concurrently on coronary computed tomography angiography (CCTA), while in the emergency room being evaluated for chest pain. Patient was medically observed without any invasive procedure since he was deemed to have low cardiovascular risk. Subsequently, literature on prevalence, as well as high risk findings are reviewed. Further studies to evaluate pharmacological, angiographic, and surgical interventions may have additional benefit for both patients and practitioners. Our aim is to help shed the light on difficulties cardiologists are facing during angiography. Additionally, our paper offers some guidance for how to evaluate and follow patients with similar findings into the future.
冠状动脉异常(CAAs)是指起源和结构上的解剖学畸变。由于解剖变异的多样性,外科医生和血管造影师在面对患有CAA的患者时一直感到棘手。为了梳理围绕CAA的复杂问题,我们呈现了一个年轻患者的病例,该患者在因胸痛于急诊室接受评估时,冠状动脉计算机断层扫描血管造影(CCTA)检查发现同时存在两种CAA。由于该患者被认为心血管风险较低,因此在未进行任何侵入性操作的情况下接受了医学观察。随后,对患病率以及高风险发现的文献进行了综述。进一步评估药物、血管造影和手术干预的研究可能会给患者和从业者带来更多益处。我们的目的是帮助阐明心脏病专家在血管造影过程中所面临的困难。此外,我们的论文为未来如何评估和随访有类似发现的患者提供了一些指导。