Alkhulaifi AM, Chooriyil N, Alkuwari M, Ghareep AN, Carr C. Coronary artery anomalies: Unusually high incidence of anomalies with a malignant course in an Asian population.
SAGE Open Med 2017;
5:2050312117741823. [PMID:
29163951 PMCID:
PMC5692126 DOI:
10.1177/2050312117741823]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 10/16/2017] [Indexed: 11/24/2022] Open
Abstract
Objectives:
Coronary artery anomalies are uncommon, but important cardiac malformations, representing the second commonest cause of death in young athletes.
Methods:
We utilized computerized tomographic angiography to screen and precisely delineate coronary artery anomalies in patients with minimal cardiac symptoms.
Results:
During 3.5-year period, we performed 2888 computerized tomographic angiographies. A total of 33 (1.1%; 95% confidence interval = 0.7–1.5) cases of coronary artery anomalies were identified (mean age = 44 ± 13.5 (15–70) years). In total, 23 patients (mean age = 43 years) had malignant coronary artery anomalies with an inter-arterial course of the aberrant vessel: of which 3 had left main coronary artery arising from right coronary sinus and 20 right coronary artery from left sinus; 19 patients were of Asian and 14 were of Arab origins. Of interest, 21 out of 33 patients had chest pain, 5 had palpitations, and 2 had breathlessness. There were no examples of sudden cardiac death. All patients received appropriate advice regarding physical exertion and medical management, and remained well for 2–5 years of follow-up. Of 33 patients, 4 had significant symptomatic coronary artery disease requiring intervention: 1 percutaneous coronary intervention and 3 coronary artery bypass graft surgery.
Conclusion:
There is a relatively high incidence of coronary artery anomalies with malignant course in Asians. The vast majority were managed conservatively.
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