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Haemodynamic significance of an anomalous right coronary with inter-arterial course assessed with intracoronary pressure measurements during dobutamine challenge |
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| Authors: | Dimopoulos Konstantinos Di Mario Carlo Barlis Peter Pennell Dudley Goktekin Omer Kaddoura Sam Gatzoulis Michael A |
| Affiliation: | aAdult Congenital Heart Program, Department of Cardiology, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK bDepartment of Clinical Cardiology, National Heart and Lung Institute, Imperial College School of Medicine, London, UK cCardiac Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London, UK dDepartment of Cardiology, Chelsea and Westminster Hospital, London, UK |
| Abstract: | 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. |
| Keywords: | Anomalous coronary artery Dobutamine stress Fractional flow reserve Congenital heart disease |
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