Haemodynamic significance of an anomalous right coronary with inter-arterial course assessed with intracoronary pressure measurements during dobutamine challenge.
Autopsy studies have associated congenital coronary anomalies with the risk of sudden cardiac death. However, not all patients with anomalous coronary arteries die suddenly. A means of assessing the potential for ischaemia and thus predicting the risk of sudden death in these patients may be necessary for directing treatment. We present the case of a patient with an anomalous right coronary artery originating from the aortic wall above the left sinus of Valsalva, with an anterior inter-arterial course. The haemodynamic significance of this anomaly was assessed using intracoronary pressure-wire measurements at rest and during dobutamine stress. This technique could be a valid means for assessing stress-induced ischaemia and, therefore, by inference, the risk of sudden cardiac death in these patients.
Dimopoulos
Konstantinos
K
Di Mario
Carlo
C
Barlis
Peter
P
Pennell
Dudley
D
Goktekin
Omer
O
Kaddoura
Sam
S
Gatzoulis
Michael A
MA
D002408:Catheters, Indwelling; D017023:Coronary Angiography / Q000379:methods; D003330:Coronary Vessel Anomalies / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D003331:Coronary Vessels / Q000187:drug effects / Q000502:physiology; D004280:Dobutamine / Q000494:pharmacology; D005260:Female; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008875:Middle Aged
D004280:Dobutamine