Anomalous aortic origin of coronary arteries

摘要: SUMMARY Among 7,000 patients who underwent diagnostic coronary arteriography at Hahnemann Medical College and Hospital, we found 45 (0.64%) with anomalous aortic origin of one or more arteries. There were 31 men (69%) 14 women (31%). The classified into the following groups: 1) circumflex artery (26 patients, 57.8%); 2) both arteries arising from left sinus Valsalva (12 26.7%); 3) right (four 8.9%); 4) anterior descending (two patients); 5) first septal perforator (three in these it was an isolated finding, other two there vessels. Associated valvular heart disease present (31%); 11 (24.5%); idiopathic hypertrophic subaortic stenosis two; miscellaneous diseases eight (17.8%); no (24.5%). Angina pectoris 42.2%; atypical chest pain 28.9%; syncope 17.7%; palpitations 46.7%; a history hypertension 40%. We conclude that are associated high incidence sample studied; palpitations, but this symptoms difficult to evaluate because disease; certain main (LM) Valsalva, myocardial perfusion is probably impaired may be serious cardiac events whether initial course LM posterior aorta, between aorta pulmonary artery, and/or artery. Course sudden death. Atherosclerosis single proximal its branching additional liability anomaly. Since death occurs most commonly young individuals LM, special care should taken resembling angina. A maximal treadmill exercise test performed first, if evidence ischemia, arteriogram performed. Recognition their also important undergoing surgery for aortocoronary bypass when needed.