title: [Abnormal origin of the ramus circumflexus sinister from the left atrium in a 30-year-old patient with aortic isthmus stenosis and atrial septal defect].
abstract: In this case report a 30-year-old woman suffering from progressive angina pectoris and dyspnea, having been operated on previously for atrial septum defect at the age of 19 and later aged 24 for coarctation of the aorta, is described. Upon observation, patient showed cardiac symptoms already under mild stress and remained resistant to nitroglycerin. Rest-ECG and serum cardiac enzymes were repeatedly without findings, while stress-ECG at a level of 100 W showed a ST-segment depression of 0.15 mV, at the same time complaining of angina pectoris symptoms. Coronary angiography revealed a left circumflex coronary artery arising from the left atrium being fully supplied by the left anterior descendent artery and the right coronary artery via pronounced collaterals, both originating from the ascending aorta. Despite such severe symptoms patient refused surgery suturing the abnormally arising artery. One year following coronary angiography patient is suffering from stabile angina pectoris without occurrence of myocardial infarction or another cardiovascular event.
authors.affiliation: Medizinischen Universitätsklinik, Kardiologie, Universität Graz.
authors.forename: B
authors.initials: B
authors.lastname: Eber
authors.forename: D
authors.initials: D
authors.lastname: Kohlhauser
authors.forename: O
authors.initials: O
authors.lastname: Luha
authors.forename: T
authors.initials: T
authors.lastname: Schneider
authors.forename: K
authors.initials: K
authors.lastname: Kilzer
authors.forename: W
authors.initials: W
authors.lastname: Klein
mesh_terms: D000328:Adult; D001017:Aortic Coarctation / Q000000981:diagnostic imaging* / Q000601:surgery; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging
vernacular_title: Fehlabgang des Ramus circumflexus sinister aus dem linken Vorhof bei einer 30jährigen Patientin mit Aortenisthmusstenose und Vorhofseptumdefekt.