Anomalous coronary arteries: Difference between revisions
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==Background== | ==Background== | ||
*Coronary arteries arise from the truncus arteriosus as endothelial buds, during this process abnormal involution, bud positioning, or septation of the truncus arteriosus may lead to abnormal origin of the coronary arteries | |||
*Types | |||
**Left circumflex from right sinus of valsalva | |||
**Single coronary artery from the left sinus of valsalva | |||
**Both coronary arteries from the right sinus of valsalva | |||
**LAD from the right sinus of valsalva | |||
*Symptoms occur due to the path that these arteries take to supply the heart, some coursing between the aorta and pulmonary arteries which results in compression, or taking abrupt turns causing acute angles that are predisposed to obstruction | |||
==Clinical Features== | ==Clinical Features== | ||
*Anginal chest pain | |||
*Syncope | |||
*Sudden death | |||
**In one study accounted for 13% of cases of sudden death in competitive athletes <ref>Relationship of race to sudden cardiac death in competitive athletes with hypertrophic cardiomyopathy. AU Maron BJ, Carney KP, Lever HM, Lewis JF, Barac I, Casey SA, Sherrid MV SO. J Am Coll Cardiol. 2003;41(6):974</ref> | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 9: | Line 17: | ||
==Evaluation== | ==Evaluation== | ||
*EKG | |||
*CXR | |||
*Troponin | |||
==Management== | ==Management== | ||
*Definitive treatment is surgery | |||
==Disposition== | ==Disposition== | ||
*Cardiology consult | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Koenig, P R, & Hijazi, Z. (2016). Congenital and pediatric coronary artery abnormalities. In G. M. Saperia (Ed.), UpToDate. Retrieved August 13, 2018, from https://www.uptodate.com/contents/congenital-and-pediatric-coronary-artery-abnormalities | |||
[[Category: Cardiology]] | [[Category: Cardiology]] | ||
[[Category: Pediatrics]] | [[Category: Pediatrics]] | ||
Revision as of 18:31, 13 August 2018
Background
- Coronary arteries arise from the truncus arteriosus as endothelial buds, during this process abnormal involution, bud positioning, or septation of the truncus arteriosus may lead to abnormal origin of the coronary arteries
- Types
- Left circumflex from right sinus of valsalva
- Single coronary artery from the left sinus of valsalva
- Both coronary arteries from the right sinus of valsalva
- LAD from the right sinus of valsalva
- Symptoms occur due to the path that these arteries take to supply the heart, some coursing between the aorta and pulmonary arteries which results in compression, or taking abrupt turns causing acute angles that are predisposed to obstruction
Clinical Features
- Anginal chest pain
- Syncope
- Sudden death
- In one study accounted for 13% of cases of sudden death in competitive athletes [1]
Differential Diagnosis
Evaluation
- EKG
- CXR
- Troponin
Management
- Definitive treatment is surgery
Disposition
- Cardiology consult
References
- ↑ Relationship of race to sudden cardiac death in competitive athletes with hypertrophic cardiomyopathy. AU Maron BJ, Carney KP, Lever HM, Lewis JF, Barac I, Casey SA, Sherrid MV SO. J Am Coll Cardiol. 2003;41(6):974
Koenig, P R, & Hijazi, Z. (2016). Congenital and pediatric coronary artery abnormalities. In G. M. Saperia (Ed.), UpToDate. Retrieved August 13, 2018, from https://www.uptodate.com/contents/congenital-and-pediatric-coronary-artery-abnormalities