McCray LC, Fogwe DT, Aggarwal K, Karuparthi PR. Novel Assessment of Ischemia in Patients With Anomalous Right Coronary Artery.
JACC Case Rep 2019;
1:819-822. [PMID:
34316939 PMCID:
PMC8289109 DOI:
10.1016/j.jaccas.2019.11.013]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/03/2019] [Accepted: 11/04/2019] [Indexed: 11/25/2022]
Abstract
Anomalous right coronary arteries are usually benign; however, sudden death owing to myocardial ischemia, especially during exertion, have been reported in patients with intramural or interarterial course, which is likely due to dynamic obstruction. We propose a novel method of physiological evaluation with instantaneous wave-free ratio with dobutamine infusion to simulate controlled dynamic obstruction in anomalous right coronary arteries. (Level of Difficulty: Intermediate.)
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