The risk of miocardial infarction on a patient with coronary emerging abnormalities

Introduction: According to the literature, coronary abnormalities are a rare pathology with a population incidence of about 1-5%. Mostly asymptomatic, it is important not to lose sight of the fact that they may have the first manifestation of myocardial infarction or sudden death, reason For their understanding of their clinical impact, it is essential to establish the mecha-nism by which they interfere with the function of the coronary, that is to ensure the blood supply necessary for proper functioning of the myocardium. Of all the anomalies coronary arteries, coronary emergencies have the most significant clinical repercussions, ran-ging from various degrees of myocardial ischemia, heart failure, arrhythmias and even sudden death.
Methods: I will present the case to a 64-year-old, hyper-tensive, dyslipidemic patient who claims earlier chest pain and fast-paced palpitations. The EKG records Rs, Av 75 bpm, where T negatives in DI, AVL, V1-V4 with broad complex tachyarrhythmia (BRD), which were interpreted as paroxysmal atrial fibrillation after exclu-ding ventricular tachycardia. The patient performs an emergency coronary artery that reveals an abnormality of the coronary system, with a common origin of the three coronary arteries and different cages of the right cusp. The ACD equivalence shows 50-70% serial ste-nosis, ACX equivalence without significant lesions and total distal occlusion of the of the third vessel (ADA equivalent). During hospitalization there are repeated episodes of paroxysmal FIA.
Results: The majority of patients with coronary abnor-malities are diagnosed following the coronary revascu-larization procedure given that most of them present with myocardial ischemia phenomena of varying de-grees, this being the most frequent manifestation ma-nifested in various specialty studies. Other diagnostic tools, such as CT angiography, considered the method of choice for the diagnosis of anomalies, were impossi-ble to do at our hospital. Analyzing the presented case, an acute / recent complication of myocardial infarcti-on with early rhythm disorders, in which the aetiology of the coronary system abnormal, is under discussion. Coronary emergence abnormalities are able to promo-te, through their own physiopathological mechanisms, myocardial ischemia and cardiac insufficiency through the anatomically deviated tract that presents compressi-on and angulation zones that cause disruption of blood flow. Of course, we do not undermine the contribution of risk factors such as dyslipidemia, hypertension, pre-sent in the reported case, factors identified as negative frequency and prognosis in the specialty studies Conclusions: Coronary abnormalities are currently an identifiable entity that would require the establishment in the future of solid screening protocols in the gene-ral population, diagnosis, follow-up and treatment. It is also important to identify the cardiovascular risk factors recognized by their involvement in myocardial ischemia phenomena, factors that increase the negative prognosis of the carriers. Symptomatic patients, depen-ding on the severity of the clinical repercussions, may require simple observation or medical treatment, co-ronary angioplasty with stent implantation, or surgical repair of vessels.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)