Anomalous coronary arteries: Difference between revisions
(Text replacement - "*Troponin" to "*Troponin") |
ClaireLewis (talk | contribs) No edit summary |
||
| Line 10: | Line 10: | ||
==Clinical Features== | ==Clinical Features== | ||
*Anginal chest pain | *Anginal [[chest pain]] | ||
*Syncope | *[[Syncope]] | ||
*Sudden death | *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> | **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== | ||
*Chest Pain | *[[Chest Pain]] | ||
**[[ACS]] | **[[ACS]] | ||
**[[Pneumothorax]] | **[[Pneumothorax]] | ||
| Line 22: | Line 22: | ||
**[[Prinzmetal's angina]] | **[[Prinzmetal's angina]] | ||
**[[Esophagitis]] | **[[Esophagitis]] | ||
**[[ | **[[Costochondritis]] | ||
**Precordial catch | **Precordial catch | ||
*Syncope | *[[Syncope]] | ||
**[[HOCM]] | **[[HOCM]] | ||
**[[Brugada Syndrome]] | **[[Brugada Syndrome]] | ||
**[[Dysrhythmias]] | **[[Dysrhythmias]] | ||
**[[Long QT syndrome]] | **[[Long QT syndrome]] | ||
**Seizure | **[[Seizure]] | ||
==Evaluation== | ==Evaluation== | ||
*EKG | *[[EKG]] | ||
*CXR | *[[CXR]] | ||
*[[Troponin]] | *[[Troponin]] | ||
*Echocardiography | *[[Echocardiography]] | ||
*Noninvasive coronary magnetic resonance angiography (CMRA) | *Noninvasive coronary magnetic resonance angiography (CMRA) | ||
**The best option if available | **The best option if available | ||
Revision as of 15:12, 12 September 2019
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
- Incidence is 0.64% of births
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
- Chest Pain
- ACS
- Pneumothorax
- Pericarditis
- Prinzmetal's angina
- Esophagitis
- Costochondritis
- Precordial catch
- Syncope
Evaluation
- EKG
- CXR
- Troponin
- Echocardiography
- Noninvasive coronary magnetic resonance angiography (CMRA)
- The best option if available
- Coronary angiography
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