Raymond Catherine, Rudy Raquel, Jacob Chris, Crawford Joan
Internal Medicine, Ascension Macomb-Oakland Hospital, Warren, USA.
Cardiology, Ascension Macomb-Oakland Hospital, Warren, USA.
Cureus. 2024 Nov 12;16(11):e73516. doi: 10.7759/cureus.73516. eCollection 2024 Nov.
Coronary artery anomalies are rare congenital defects that involve abnormalities in the origin, course, or termination of the three main epicardial coronary arteries. Due to the variety of aberrant coronary artery defects, the clinical presentation can differ. Anomalous origins of the right coronary artery include the pulmonary trunk, ascending aorta, left sinus of Valsalva, and a course that traverses between the great vessels. Diagnosis is made using multidetector computed tomography coronary angiography or coronary computed tomography angiography. Management may include lifestyle modifications, medications, or invasive surgical interventions. Here, we present the case of a 65-year-old woman with recurrent angina, leading to multiple emergency visits and hospitalizations. The patient was ultimately diagnosed with an anomalous right coronary artery, with a high takeoff originating anteriorly above the sinus of Valsalva and traversing normally after a short segment between the aorta and the main pulmonary artery. This case highlights the complex and controversial management of anomalous coronary arteries and underscores the need for further research to establish optimal, guideline-directed treatment strategies.
冠状动脉异常是罕见的先天性缺陷，涉及三条主要心外膜冠状动脉的起源、走行或终末异常。由于冠状动脉异常缺陷的多样性，临床表现可能有所不同。右冠状动脉异常起源包括肺动脉干、升主动脉、左冠窦，以及走行于大血管之间。诊断采用多排螺旋计算机断层扫描冠状动脉造影或冠状动脉计算机断层扫描血管造影。治疗可能包括生活方式改变、药物治疗或侵入性手术干预。在此，我们报告一例65岁女性反复心绞痛病例，导致多次急诊就诊和住院。该患者最终被诊断为右冠状动脉异常，高位起源于Valsalva窦前方，在主动脉和主肺动脉之间短距离走行后正常走行。本病例突出了冠状动脉异常复杂且有争议的治疗，并强调需要进一步研究以建立最佳的、遵循指南的治疗策略。
