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Single coronary artery originating from the right sinus Valsalva and ability to work.

De Rosa R, Ratti G, Gerardi D, Tedeschi C, Lamberti M - Ann Occup Environ Med (2015)

Bottom Line: After cardioversion, conventional coronary angiography revealed a suspect of single coronary vessel (SCA) arising from the right sinus of Valsalva.The patient underwent multislice computed tomography that showed a SCA arising from the right sinus Valsalva and dividing in Right Coronary Artery (RCA) and Left Main coronary artery (LM).The finding of posterior course of the LM without atherosclerotic has proved crucial for the expression of an opinion of working capacity even with limitation.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, PSI ASL Napoli 1, (Via Ciccarelli 1), Naples, (80100) Italy.

ABSTRACT
We present a case of a 56-year-old male electrician who was admitted to the hospital with atrial fibrillation, atypical chest pain and dyspnea. He gave a history that on the morning he had working for almost 4 hours carrying out various activities with considerable physical effort. After cardioversion, conventional coronary angiography revealed a suspect of single coronary vessel (SCA) arising from the right sinus of Valsalva. The patient underwent multislice computed tomography that showed a SCA arising from the right sinus Valsalva and dividing in Right Coronary Artery (RCA) and Left Main coronary artery (LM). The finding of posterior course of the LM without atherosclerotic has proved crucial for the expression of an opinion of working capacity even with limitation.

No MeSH data available.


Related in: MedlinePlus

Coronary angiography, volume rendering and curved multiplanar reconstruction from MSCT of the coronary anomalies. (Panel A) Coronary Angiography (CAG) projection showing a Single Coronary Artery (SCA) arising from right sinus of Valsalva and dividing in right coronary artery (RCA) and Left Main (LM). Volume rendering (panel B and C) and Curved Multiplanar Reconstruction (panel D) from MSCT showed that LM turned posteriorly behind the aorta (non-malignant anomaly), reaching the atrio-ventricular groove where it divides into left anterior descending (LAD) and left circumflex (CX) arteries.
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Fig1: Coronary angiography, volume rendering and curved multiplanar reconstruction from MSCT of the coronary anomalies. (Panel A) Coronary Angiography (CAG) projection showing a Single Coronary Artery (SCA) arising from right sinus of Valsalva and dividing in right coronary artery (RCA) and Left Main (LM). Volume rendering (panel B and C) and Curved Multiplanar Reconstruction (panel D) from MSCT showed that LM turned posteriorly behind the aorta (non-malignant anomaly), reaching the atrio-ventricular groove where it divides into left anterior descending (LAD) and left circumflex (CX) arteries.

Mentions: In his clinical history he reported to have had occasional atypical chest pain for which he submitted two years ago to exercise stress testing, which resulted maximal for age and negative for ischaemia induced by stress. The patient on admission had tachypnoea at rest with oxygen saturation of 93%. Electrocardiogram (ECG) showed atrial fibrillation with a heart rate of 90 beats/min. Blood pressure was 175/95 mm Hg. Cardiac auscultation was normal but at pulmonary level bilateral basal crackles were present. Cardiac enzymes were slightly elevated: Troponin T (TnT): 0,033 ng/l [norm: <0.03] and Creatine Kinase (CK): 260 U/l [norm: 47–220]. Regional left ventricular wall motion and ejection fraction was normal (Ejection Fraction EF 60%). After cardioversion with DC shock (3 J/Kg body weight), considering TnT and CK levels [3] a CAG was performed to exclude coronary disease. It revealed a suspect of single coronary vessel arising from the right sinus of Valsalva. The right coronary artery (RCA) showed a normal course (Figure 1: panel A). Stenoses of the coronary arteries were not present. In order to better define the origin and course of the single vessel, we performed a Multi Slices Computed Tomography (MSCT) (Figure 1: panels B, C and D) using a 64-detector-row scanner (Aquilion 64; Toshiba Medical System, Tokyo, Japan).Figure 1


Single coronary artery originating from the right sinus Valsalva and ability to work.

De Rosa R, Ratti G, Gerardi D, Tedeschi C, Lamberti M - Ann Occup Environ Med (2015)

Coronary angiography, volume rendering and curved multiplanar reconstruction from MSCT of the coronary anomalies. (Panel A) Coronary Angiography (CAG) projection showing a Single Coronary Artery (SCA) arising from right sinus of Valsalva and dividing in right coronary artery (RCA) and Left Main (LM). Volume rendering (panel B and C) and Curved Multiplanar Reconstruction (panel D) from MSCT showed that LM turned posteriorly behind the aorta (non-malignant anomaly), reaching the atrio-ventricular groove where it divides into left anterior descending (LAD) and left circumflex (CX) arteries.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4358708&req=5

Fig1: Coronary angiography, volume rendering and curved multiplanar reconstruction from MSCT of the coronary anomalies. (Panel A) Coronary Angiography (CAG) projection showing a Single Coronary Artery (SCA) arising from right sinus of Valsalva and dividing in right coronary artery (RCA) and Left Main (LM). Volume rendering (panel B and C) and Curved Multiplanar Reconstruction (panel D) from MSCT showed that LM turned posteriorly behind the aorta (non-malignant anomaly), reaching the atrio-ventricular groove where it divides into left anterior descending (LAD) and left circumflex (CX) arteries.
Mentions: In his clinical history he reported to have had occasional atypical chest pain for which he submitted two years ago to exercise stress testing, which resulted maximal for age and negative for ischaemia induced by stress. The patient on admission had tachypnoea at rest with oxygen saturation of 93%. Electrocardiogram (ECG) showed atrial fibrillation with a heart rate of 90 beats/min. Blood pressure was 175/95 mm Hg. Cardiac auscultation was normal but at pulmonary level bilateral basal crackles were present. Cardiac enzymes were slightly elevated: Troponin T (TnT): 0,033 ng/l [norm: <0.03] and Creatine Kinase (CK): 260 U/l [norm: 47–220]. Regional left ventricular wall motion and ejection fraction was normal (Ejection Fraction EF 60%). After cardioversion with DC shock (3 J/Kg body weight), considering TnT and CK levels [3] a CAG was performed to exclude coronary disease. It revealed a suspect of single coronary vessel arising from the right sinus of Valsalva. The right coronary artery (RCA) showed a normal course (Figure 1: panel A). Stenoses of the coronary arteries were not present. In order to better define the origin and course of the single vessel, we performed a Multi Slices Computed Tomography (MSCT) (Figure 1: panels B, C and D) using a 64-detector-row scanner (Aquilion 64; Toshiba Medical System, Tokyo, Japan).Figure 1

Bottom Line: After cardioversion, conventional coronary angiography revealed a suspect of single coronary vessel (SCA) arising from the right sinus of Valsalva.The patient underwent multislice computed tomography that showed a SCA arising from the right sinus Valsalva and dividing in Right Coronary Artery (RCA) and Left Main coronary artery (LM).The finding of posterior course of the LM without atherosclerotic has proved crucial for the expression of an opinion of working capacity even with limitation.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, PSI ASL Napoli 1, (Via Ciccarelli 1), Naples, (80100) Italy.

ABSTRACT
We present a case of a 56-year-old male electrician who was admitted to the hospital with atrial fibrillation, atypical chest pain and dyspnea. He gave a history that on the morning he had working for almost 4 hours carrying out various activities with considerable physical effort. After cardioversion, conventional coronary angiography revealed a suspect of single coronary vessel (SCA) arising from the right sinus of Valsalva. The patient underwent multislice computed tomography that showed a SCA arising from the right sinus Valsalva and dividing in Right Coronary Artery (RCA) and Left Main coronary artery (LM). The finding of posterior course of the LM without atherosclerotic has proved crucial for the expression of an opinion of working capacity even with limitation.

No MeSH data available.


Related in: MedlinePlus