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Strenuous exercise induced syncope due to coronary artery anomaly.

Yavuz V, Cetin N, Tuncer E, Dalgic O, Taskin U, Bilge AR, Tikiz H - Int Cardiovasc Res J (2014)

Bottom Line: Coronary artery anomalies are among the neglected topics in cardiology.Anomalous origin of the left main coronary artery from the right sinus of valsalva is a rare coronary anomaly observed in 0.15% of patients.Patients experiencing exercise induced syncope accompanied by symptoms of coronary ischemia (typically: chest pain, ischemic findings on ECG, and raised cardiac markers) should be referred to diagnostic coronary angiography.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Department, Akhisar State Hospital, Manisa, Turkey.

ABSTRACT
Coronary artery anomalies are among the neglected topics in cardiology. Anomalous origin of the left main coronary artery from the right sinus of valsalva is a rare coronary anomaly observed in 0.15% of patients. During exercise, the distended aorta and pulmonary artery with increased blood flow may squeeze the Left Main Coronary Artery (LMCA) between them. Even though arrhythmias are common causes of syncope, one should also think about aberrant coronary artery in the patients with syncope of unexplained origin. Patients experiencing exercise induced syncope accompanied by symptoms of coronary ischemia (typically: chest pain, ischemic findings on ECG, and raised cardiac markers) should be referred to diagnostic coronary angiography.

No MeSH data available.


Related in: MedlinePlus

(a) Coronary Angiography Demonstrated an Anomalous Left Main Coronary Artery (LMCA) Arising from the Right Sinus of Valsalva (b) Right Coronary Artery (RCA) Arose from Appropriate Sinus but Different Origin
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fig11933: (a) Coronary Angiography Demonstrated an Anomalous Left Main Coronary Artery (LMCA) Arising from the Right Sinus of Valsalva (b) Right Coronary Artery (RCA) Arose from Appropriate Sinus but Different Origin

Mentions: A 50 year old man experienced syncope after rigorous exercise lasting for about 1 minute and resolving spontaneously for 5 years. His last syncope was accompanied by persistent chest pain. He was referred to our center with acute coronary syndrome. On admission, he had mild but persistent chest pain. He was conscious and had bardycardia (50 bpm). Additionally, his blood pressure was 165/90 mmHg. His medical history revealed hypertension treated with perindopril and amlodipin. He had sinus bradycardia at 55 bpm and negative T waves in DIII and aVF derivations on ECG (Figure 3). Also, he had increased troponin value (1.23 ng/mL), while his CKMB was within the normal range. He had mild left ventricular concentric hypertrophy with normal systolic function on echocardiography. He was referred to coronary angiography due to persistent chest pain. Accordingly, he had an aberrant LMCA arising from the right sinus of valsalva (Figure 4a). The right coronary artery was emerging from a separate ostium on the right sinus of valsalva (Figure 4b).


Strenuous exercise induced syncope due to coronary artery anomaly.

Yavuz V, Cetin N, Tuncer E, Dalgic O, Taskin U, Bilge AR, Tikiz H - Int Cardiovasc Res J (2014)

(a) Coronary Angiography Demonstrated an Anomalous Left Main Coronary Artery (LMCA) Arising from the Right Sinus of Valsalva (b) Right Coronary Artery (RCA) Arose from Appropriate Sinus but Different Origin
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4109038&req=5

fig11933: (a) Coronary Angiography Demonstrated an Anomalous Left Main Coronary Artery (LMCA) Arising from the Right Sinus of Valsalva (b) Right Coronary Artery (RCA) Arose from Appropriate Sinus but Different Origin
Mentions: A 50 year old man experienced syncope after rigorous exercise lasting for about 1 minute and resolving spontaneously for 5 years. His last syncope was accompanied by persistent chest pain. He was referred to our center with acute coronary syndrome. On admission, he had mild but persistent chest pain. He was conscious and had bardycardia (50 bpm). Additionally, his blood pressure was 165/90 mmHg. His medical history revealed hypertension treated with perindopril and amlodipin. He had sinus bradycardia at 55 bpm and negative T waves in DIII and aVF derivations on ECG (Figure 3). Also, he had increased troponin value (1.23 ng/mL), while his CKMB was within the normal range. He had mild left ventricular concentric hypertrophy with normal systolic function on echocardiography. He was referred to coronary angiography due to persistent chest pain. Accordingly, he had an aberrant LMCA arising from the right sinus of valsalva (Figure 4a). The right coronary artery was emerging from a separate ostium on the right sinus of valsalva (Figure 4b).

Bottom Line: Coronary artery anomalies are among the neglected topics in cardiology.Anomalous origin of the left main coronary artery from the right sinus of valsalva is a rare coronary anomaly observed in 0.15% of patients.Patients experiencing exercise induced syncope accompanied by symptoms of coronary ischemia (typically: chest pain, ischemic findings on ECG, and raised cardiac markers) should be referred to diagnostic coronary angiography.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Department, Akhisar State Hospital, Manisa, Turkey.

ABSTRACT
Coronary artery anomalies are among the neglected topics in cardiology. Anomalous origin of the left main coronary artery from the right sinus of valsalva is a rare coronary anomaly observed in 0.15% of patients. During exercise, the distended aorta and pulmonary artery with increased blood flow may squeeze the Left Main Coronary Artery (LMCA) between them. Even though arrhythmias are common causes of syncope, one should also think about aberrant coronary artery in the patients with syncope of unexplained origin. Patients experiencing exercise induced syncope accompanied by symptoms of coronary ischemia (typically: chest pain, ischemic findings on ECG, and raised cardiac markers) should be referred to diagnostic coronary angiography.

No MeSH data available.


Related in: MedlinePlus