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Patients with varying courses of single coronary artery: case series

BACKGROUND: Single coronary artery (SCA) is a rare congenital anomaly where blood to the heart is supplied through a common trunk. Identifying these abnormalities is important because some variants can compromise myocardial blood flow and increase risk of sudden cardiac death. CASE SUMMARY: We prese...

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Autores principales: Sheng, Calvin C, Ghobrial, Joanna, Cho, Leslie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515176/
https://www.ncbi.nlm.nih.gov/pubmed/34661051
http://dx.doi.org/10.1093/ehjcr/ytab314
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author Sheng, Calvin C
Ghobrial, Joanna
Cho, Leslie
author_facet Sheng, Calvin C
Ghobrial, Joanna
Cho, Leslie
author_sort Sheng, Calvin C
collection PubMed
description BACKGROUND: Single coronary artery (SCA) is a rare congenital anomaly where blood to the heart is supplied through a common trunk. Identifying these abnormalities is important because some variants can compromise myocardial blood flow and increase risk of sudden cardiac death. CASE SUMMARY: We present five patients with varying Lipton Group I and Group II SCA subtypes, corroborated on multi-imaging modalities and evaluated with comprehensive non-invasive as well as invasive testing. Their clinical presentations also vary from a spectrum of asymptomatic finding to angina equivalent. The decision for definitive surgical intervention involving unroofing of the involved vessel depends largely on symptoms and evidence of myocardial ischaemia. DISCUSSION: While SCA findings are often incidental and benign, understanding the origin, branching pattern, and course of the anomalous artery has implications in prognosis and treatment. This usually involves a combination of anatomic assessment with imaging such as coronary Computed Tomography Angiography (CTA), Magnetic Resonance Angiography (MRA), and/or coronary angiography as well as functional assessment with invasive testing using tools like instantaneous wave-free ratio and intravascular ultrasound both at rest and with stress. Individualized treatment plans can then be made through a multidisciplinary approach involving adult congenital heart disease specialists and congenital cardiothoracic surgeons.
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spelling pubmed-85151762021-10-15 Patients with varying courses of single coronary artery: case series Sheng, Calvin C Ghobrial, Joanna Cho, Leslie Eur Heart J Case Rep Case Series BACKGROUND: Single coronary artery (SCA) is a rare congenital anomaly where blood to the heart is supplied through a common trunk. Identifying these abnormalities is important because some variants can compromise myocardial blood flow and increase risk of sudden cardiac death. CASE SUMMARY: We present five patients with varying Lipton Group I and Group II SCA subtypes, corroborated on multi-imaging modalities and evaluated with comprehensive non-invasive as well as invasive testing. Their clinical presentations also vary from a spectrum of asymptomatic finding to angina equivalent. The decision for definitive surgical intervention involving unroofing of the involved vessel depends largely on symptoms and evidence of myocardial ischaemia. DISCUSSION: While SCA findings are often incidental and benign, understanding the origin, branching pattern, and course of the anomalous artery has implications in prognosis and treatment. This usually involves a combination of anatomic assessment with imaging such as coronary Computed Tomography Angiography (CTA), Magnetic Resonance Angiography (MRA), and/or coronary angiography as well as functional assessment with invasive testing using tools like instantaneous wave-free ratio and intravascular ultrasound both at rest and with stress. Individualized treatment plans can then be made through a multidisciplinary approach involving adult congenital heart disease specialists and congenital cardiothoracic surgeons. Oxford University Press 2021-09-03 /pmc/articles/PMC8515176/ /pubmed/34661051 http://dx.doi.org/10.1093/ehjcr/ytab314 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Series
Sheng, Calvin C
Ghobrial, Joanna
Cho, Leslie
Patients with varying courses of single coronary artery: case series
title Patients with varying courses of single coronary artery: case series
title_full Patients with varying courses of single coronary artery: case series
title_fullStr Patients with varying courses of single coronary artery: case series
title_full_unstemmed Patients with varying courses of single coronary artery: case series
title_short Patients with varying courses of single coronary artery: case series
title_sort patients with varying courses of single coronary artery: case series
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515176/
https://www.ncbi.nlm.nih.gov/pubmed/34661051
http://dx.doi.org/10.1093/ehjcr/ytab314
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