TY - JOUR
T1 - Ultrasonographic and radiological imaging demonstrating an anomalous origin of the left coronary artery causing acute coronary syndrome in an adolescent
AU - Taniguchi, Toshio
AU - Umemoto, Norio
AU - Ishii, Hideki
AU - Nakahata, Kazuhiko
AU - Shibata, Naoki
AU - Mizutani, Takashi
AU - Yamada, Michiharu
AU - Shimizu, Kiyokazu
AU - Murohara, Toyoaki
N1 - Funding Information:
Toyoaki Murohara received lecture fees from Bayer Pharmaceutical Co., Ltd., Daiichi-Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K. K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K. K., Pfizer Japan Inc., Sanofi-aventis K. K., and Takeda Pharmaceutical Co., Ltd. Toyoaki Murohara received unrestricted research grant for Department of Cardiology, Nagoya University Graduate School of Medicine from Astellas Pharma Inc., Daiichi-Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K. K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K. K., Otsuka Pharma Ltd., Pfizer Japan Inc., Sanofi-aventis K. K., Takeda Pharmaceutical Co., Ltd., and Teijin Pharma Ltd. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Funding Information:
The authors would like to thank Dr Hajime Sakurai (Department of Pediatric Cardiology Department, Chukyo Children's Heart Center, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan) who performed the unroofing operation in this patient after she was discharged from our intensive care unit.
Publisher Copyright:
© 2018 Japanese College of Cardiology
PY - 2018/4
Y1 - 2018/4
N2 - We report the case of a 13-year-old girl who presented with cardiac collapse secondary to compression of the left main coronary artery (LMCA) between the pulmonary artery and the ascending aorta. In the acute phase, we performed aortography, intra-vascular ultrasound (IVUS), coronary computed tomography angiography (CCTA), transthoracic echocardiography (TTE), and transesophageal echocardiography (TEE). Aortography and CCTA showed that her LMCA was located between her pulmonary artery and the ascending aorta. IVUS and TEE showed that her LMCA was narrowed owing to compression by both great vessels during systole with release of the pressure during diastole. TTE and TEE showed that the left coronary artery flow was faster in the systole than that observed in the diastole. She was initially treated at our hospital but was transferred to another hospital for an unroofing operation. This was a rare case of a patient presenting with a coronary artery anomaly causing cardiac collapse. We conclude that her LMCA stenosis secondary to compression and narrowing of the great vessels led to her cardiac collapse. <Learning objective: A 13-year-old girl presented with cardiac collapse secondary to an anomaly of the left main coronary artery. Although, this anomaly is rare, it requires close and careful attention in the clinical setting. We reckon that the distinctive multi-modal images of this coronary artery anomaly that we present with this report are impressive and would be valuable to other clinicians.>
AB - We report the case of a 13-year-old girl who presented with cardiac collapse secondary to compression of the left main coronary artery (LMCA) between the pulmonary artery and the ascending aorta. In the acute phase, we performed aortography, intra-vascular ultrasound (IVUS), coronary computed tomography angiography (CCTA), transthoracic echocardiography (TTE), and transesophageal echocardiography (TEE). Aortography and CCTA showed that her LMCA was located between her pulmonary artery and the ascending aorta. IVUS and TEE showed that her LMCA was narrowed owing to compression by both great vessels during systole with release of the pressure during diastole. TTE and TEE showed that the left coronary artery flow was faster in the systole than that observed in the diastole. She was initially treated at our hospital but was transferred to another hospital for an unroofing operation. This was a rare case of a patient presenting with a coronary artery anomaly causing cardiac collapse. We conclude that her LMCA stenosis secondary to compression and narrowing of the great vessels led to her cardiac collapse. <Learning objective: A 13-year-old girl presented with cardiac collapse secondary to an anomaly of the left main coronary artery. Although, this anomaly is rare, it requires close and careful attention in the clinical setting. We reckon that the distinctive multi-modal images of this coronary artery anomaly that we present with this report are impressive and would be valuable to other clinicians.>
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U2 - 10.1016/j.jccase.2017.12.008
DO - 10.1016/j.jccase.2017.12.008
M3 - Article
AN - SCOPUS:85041576017
SN - 1878-5409
VL - 17
SP - 141
EP - 145
JO - Journal of Cardiology Cases
JF - Journal of Cardiology Cases
IS - 4
ER -