Chronic Ischemia Induced by Woven Coronary Artery Anomaly with Typical Atrial Flutter: Insights from Multiple Imaging Devices.
A 75-year-old man with a 120-bpm tachycardia and typical atrial flutter was admitted. Echocardiography showed a dilated left ventricle with anterior and apical wall akinesia. Tachycardia was terminated with cavotricuspid isthmus ablation. Multiple imaging findings revealed a woven coronary artery anomaly (WCAA) in the left anterior descending artery. Stress myocardial perfusion imaging was performed after ablation in the sinus rhythm and revealed stress-induced ischemia and a fixed low uptake in the WCAA territory. WCAA is generally regarded as a benign condition; however, compromised blood flow within the anomaly, caused by tachycardia-related diastolic shortening, may induce ischemia.
Department of Cardiology, National Hospital Organization, Kanazawa Medical Center, Japan.
Akio
A
Chikata
Satoru
S
Sakagami
Naomi
N
Kanamori
Chieko
C
Kato
Wataru
W
Omi
Takahiro
T
Saeki
Hideo
H
Nagai
Soichiro
S
Usui
Kenichi
K
Nakajima
Masayuki
M
Takamura
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D001282:Atrial Flutter / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods*; D002908:Chronic Disease; D003331:Coronary Vessels / Q000473:pathology*; D004452:Echocardiography; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000503:physiopathology / Q000601:surgery*