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Anomalous aortic origin of right coronary artery from left coronary cusp: a management conundrum: a case report

BACKGROUND: Coronary artery anomalies are characterized by an abnormality in the course or origin of three main coronary arteries. There needs to be more scientific evidence to promptly treat coronary artery anomalies with poorly understood prognostic implications, especially anomalous aortic origin...

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Autores principales: Arun Kumar, Pramukh, Patel, Boskey, Dasari, Mahati, Bhattad, Pradnya Brijmohan, Prabhu, Sushmita, Hadley, Michelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10170789/
https://www.ncbi.nlm.nih.gov/pubmed/37161579
http://dx.doi.org/10.1186/s13256-023-03921-1
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author Arun Kumar, Pramukh
Patel, Boskey
Dasari, Mahati
Bhattad, Pradnya Brijmohan
Prabhu, Sushmita
Hadley, Michelle
author_facet Arun Kumar, Pramukh
Patel, Boskey
Dasari, Mahati
Bhattad, Pradnya Brijmohan
Prabhu, Sushmita
Hadley, Michelle
author_sort Arun Kumar, Pramukh
collection PubMed
description BACKGROUND: Coronary artery anomalies are characterized by an abnormality in the course or origin of three main coronary arteries. There needs to be more scientific evidence to promptly treat coronary artery anomalies with poorly understood prognostic implications, especially anomalous aortic origin of the right coronary artery from the left coronary cusp. CASE PRESENTATION: A 58-year-old Caucasian female presented multiple times over 6 months with atypical chest discomfort and palpitations. The treadmill exercise test demonstrated exercise-induced non-sustained ventricular tachycardia. A coronary angiogram revealed no obstructive coronary artery disease and an anomalous aortic origin of the right coronary artery from the left coronary cusp with an interarterial course. She was managed conservatively with medications, despite persistent recurrent symptoms. CONCLUSION: It is essential to identify subtle symptoms and insidious onset of anomalous aortic origin of the right coronary artery symptoms as seen in our patient, which can contribute to significant morbidity. There are discrepancies in existing guidelines between different cardiovascular societies in managing selected subgroups of patients with anomalous aortic origin of the right coronary artery who do not have high-risk features, but continue to remain symptomatic. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13256-023-03921-1.
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spelling pubmed-101707892023-05-11 Anomalous aortic origin of right coronary artery from left coronary cusp: a management conundrum: a case report Arun Kumar, Pramukh Patel, Boskey Dasari, Mahati Bhattad, Pradnya Brijmohan Prabhu, Sushmita Hadley, Michelle J Med Case Rep Case Report BACKGROUND: Coronary artery anomalies are characterized by an abnormality in the course or origin of three main coronary arteries. There needs to be more scientific evidence to promptly treat coronary artery anomalies with poorly understood prognostic implications, especially anomalous aortic origin of the right coronary artery from the left coronary cusp. CASE PRESENTATION: A 58-year-old Caucasian female presented multiple times over 6 months with atypical chest discomfort and palpitations. The treadmill exercise test demonstrated exercise-induced non-sustained ventricular tachycardia. A coronary angiogram revealed no obstructive coronary artery disease and an anomalous aortic origin of the right coronary artery from the left coronary cusp with an interarterial course. She was managed conservatively with medications, despite persistent recurrent symptoms. CONCLUSION: It is essential to identify subtle symptoms and insidious onset of anomalous aortic origin of the right coronary artery symptoms as seen in our patient, which can contribute to significant morbidity. There are discrepancies in existing guidelines between different cardiovascular societies in managing selected subgroups of patients with anomalous aortic origin of the right coronary artery who do not have high-risk features, but continue to remain symptomatic. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13256-023-03921-1. BioMed Central 2023-05-10 /pmc/articles/PMC10170789/ /pubmed/37161579 http://dx.doi.org/10.1186/s13256-023-03921-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Arun Kumar, Pramukh
Patel, Boskey
Dasari, Mahati
Bhattad, Pradnya Brijmohan
Prabhu, Sushmita
Hadley, Michelle
Anomalous aortic origin of right coronary artery from left coronary cusp: a management conundrum: a case report
title Anomalous aortic origin of right coronary artery from left coronary cusp: a management conundrum: a case report
title_full Anomalous aortic origin of right coronary artery from left coronary cusp: a management conundrum: a case report
title_fullStr Anomalous aortic origin of right coronary artery from left coronary cusp: a management conundrum: a case report
title_full_unstemmed Anomalous aortic origin of right coronary artery from left coronary cusp: a management conundrum: a case report
title_short Anomalous aortic origin of right coronary artery from left coronary cusp: a management conundrum: a case report
title_sort anomalous aortic origin of right coronary artery from left coronary cusp: a management conundrum: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10170789/
https://www.ncbi.nlm.nih.gov/pubmed/37161579
http://dx.doi.org/10.1186/s13256-023-03921-1
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