Anomalous Right Coronary Artery in Stress Cardiomyopathy: Coincidental or Contributory?
Journal Title: Cardiology and Angiology: An International Journal - Year 2016, Vol 5, Issue 3
Abstract
We report a case of a 72-year-old female with no known comorbidities who presented with dizziness and dyspnea while exercising on a treadmill. Upon presentation in the hospital, she became hemodynamically unstable with multiple episodes of retching and vomiting, eventually intubated for airway protection. Electrocardiogram revealed minimal ST elevation in the lateral leads which prompted performance of coronary angiography that revealed mild luminal irregularities but noted to have an anomalous right coronary artery. Left ventriculography demonstrated severe left ventricular dysfunction with apical ballooning. Echocardiogram showed dynamic left ventricular outflow obstruction with an ejection fraction of fifteen percent. The patient was aggressively managed including administration of inotropes, then gradually transitioned to cautious initiation of beta blockers, angiotensin converting enzyme inhibitor, and aldosterone antagonist. Transthoracic echocardiogram and cardiac magnetic resonance imaging two weeks later showed improved ejection fraction of forty to fifty five percent respectively. The patient denied syncope, angina, or exertional dyspnea on subsequent health maintenance evaluation.
Authors and Affiliations
Glenmore Lasam, Jenny Lam
Keywords
Related Articles
- EP ID EP327679
- DOI 10.9734/CA/2016/27252
- Views 81
- Downloads 0
Coronary Spasm as a Cause of Recurrent Chest Pain: A Case Report
Background: Coronary artery spasm plays an important role in the pathogenesis of a wide variety of ischemic heart diseases, including myocardial infarction and sudden cardiac death. However, the diagnosis of vasospastic...
Role of Hs-CRP and Exercise Stress Echocardiography in Cardiovascular Risk Stratification of Asymptomatic Type 2 Diabetic Patients
Background: Silent ischaemia is a well known cause of mortality and morbidity in type-2 diabetic patients; however the role of high-sensitive C-Reactive Protein (hs-CRP) and exercise stress echocardiography in early dete...
Haemodynamic Responses to Tobacco Smoke Inhalation in Male Adolescents in Lusaka, Zambia
Background: Tobacco smoke is said to cause changes in the levels of catecholamines in the blood, this leads to an increase in blood pressure and heart rate. This is due to nicotine which has also been noted to cause a de...
Cautious Use of Veno-Arterial Extracorporeal Membrane Oxygenation for MRSA Sepsis and Acute Respiratory Distress Syndrome
Extracorporeal membrane oxygenation (ECMO) for septic shock has been reported occasionally and it has been shown to have reasonable outcomes in pediatrics cases. However, the adult ECMO for septic shock is not as clearl...
Impact of Cardiovascular Exercise on Antibody Isotypes of Healthy Individuals in Eastern Nigeria
Background: Cardiovascular disease is a major public health problem & a leading cause of mortality in Nigeria, which has been largely attributed to the decline in physical exercise predisposing people to various forms of...