Anwar Farhana, Hiles Ethan, Shahid Maham, Martinez Suzanne, Syed Mubbasher
Internal Medicine, Health Corporation of America (HCA) Florida Orange Park Hospital, Orange Park, USA.
Endocrinology, Health Corporation of America (HCA) Florida Orange Park Hospital, Orange Park, USA.
Cureus. 2024 Jul 2;16(7):e63705. doi: 10.7759/cureus.63705. eCollection 2024 Jul.
Anomalous coronary artery is a rare but potentially life-threatening alteration in the coronary vascular system that is related to an increased risk of myocardial ischemia, ventricular arrhythmias, heart failure, and sudden cardiac death (SCD). Here, we present the case of a young male who presented to the hospital after a witnessed sudden cardiac arrest. Bystander cardiopulmonary resuscitation was started immediately, and normal sinus rhythm was achieved after electrical cardioversion three times. He was admitted to the ICU for further care upon admission. A CT of the chest showed a potential vascular structure in between the aorta and the pulmonary trunk. He underwent cardiac catheterization, which identified minimal coronary artery disease with the anomalous takeoff of the right coronary artery from the left coronary cusp. A cardiac CT scan obtained also showed an anomalous right coronary artery (ARCA) with an inter-arterial course. After explaining available treatment options and obtaining informed consent, a surgical correction by cardiothoracic surgery was performed using the coronary artery bypass graft technique. The patient recovered well after the surgery and was discharged home. After two years of follow-up, he continued to live life normally without any symptoms. Early and accurate diagnosis of an anomalous coronary artery is imperative for timely intervention, as malignant coronary artery diseases can often have a catastrophic presentation with acute coronary syndromes, myocardial infarction, or SCD. We present here a case of successful diagnosis of ARCA and its prompt surgical correction using coronary artery bypass grafting technique in a young adult. Despite the availability of various other treatment options, our case underscores coronary artery bypass grafting as a viable choice for individuals with anomalous coronary arteries, particularly in urgent situations.
异常冠状动脉是冠状动脉系统中一种罕见但可能危及生命的改变，与心肌缺血、室性心律失常、心力衰竭和心源性猝死（SCD）风险增加有关。在此，我们报告一例年轻男性病例，该患者在目睹心源性骤停后被送往医院。旁观者立即开始进行心肺复苏，经三次电复律后恢复正常窦性心律。入院后他被收入重症监护病房进一步治疗。胸部CT显示主动脉和肺动脉干之间有一个潜在的血管结构。他接受了心导管检查，结果显示冠状动脉疾病轻微，右冠状动脉从左冠状动脉瓣叶异常起始。所做的心脏CT扫描也显示一条走行于动脉间的异常右冠状动脉（ARCA）。在向患者解释了可用的治疗方案并获得知情同意后，心胸外科采用冠状动脉搭桥术进行了手术矫正。患者术后恢复良好并出院回家。经过两年的随访，他继续正常生活，没有任何症状。对于异常冠状动脉，早期准确诊断对于及时干预至关重要，因为恶性冠状动脉疾病常常会以急性冠状动脉综合征、心肌梗死或心源性猝死等灾难性表现出现。我们在此报告一例年轻成年人成功诊断ARCA并使用冠状动脉搭桥术对其进行及时手术矫正的病例。尽管有各种其他治疗选择，但我们的病例强调冠状动脉搭桥术对于异常冠状动脉患者，尤其是在紧急情况下，是一种可行的选择。
