Ito S. Challenging situation of coronary artery anomaly associated with ischemia and/or risk of sudden death. World J Cardiol 2024; 16(4): 173-176 [PMID: 38690213 DOI: 10.4330/wjc.v16.i4.173]
Corresponding Author of This Article
Shigenori Ito, MD, PhD, Attending Doctor, Division of Cardiology, Sankuro Hospital, 7-80 Kosaka-cho, Toyota 471-0035, Japan. shigeito918@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Apr 26, 2024; 16(4): 173-176 Published online Apr 26, 2024. doi: 10.4330/wjc.v16.i4.173
Challenging situation of coronary artery anomaly associated with ischemia and/or risk of sudden death
Shigenori Ito
Shigenori Ito, Division of Cardiology, Sankuro Hospital, Toyota 471-0035, Japan
Author contributions: Ito S contributed to this paper; Ito S designed the overall concept and outline of the manuscript; Ito S contributed to the discussion and design of the manuscript; Ito S contributed to the writing, editing of the manuscript, and review of the literature.
Conflict-of-interest statement: The author has no conflict-of-interest to state.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shigenori Ito, MD, PhD, Attending Doctor, Division of Cardiology, Sankuro Hospital, 7-80 Kosaka-cho, Toyota 471-0035, Japan. shigeito918@gmail.com
Received: November 28, 2023 Peer-review started: November 28, 2023 First decision: January 17, 2024 Revised: January 28, 2024 Accepted: March 1, 2024 Article in press: March 1, 2024 Published online: April 26, 2024
Abstract
Coronary artery anomaly is known as one of the causes of angina pectoris and sudden death and is an important clinical entity that cannot be overlooked. The incidence of coronary artery anomalies is as low as 1%-2% of the general population, even when the various types are combined. Coronary anomalies are practically challenging when the left and right coronary ostium are not found around their normal positions during coronary angiography with a catheter. If there is atherosclerotic stenosis of the coronary artery with an anomaly and percutaneous coronary intervention (PCI) is required, the suitability of the guiding catheter at the entrance and the adequate back up force of the guiding catheter are issues. The level of PCI risk itself should also be considered on a case-by-case basis. In this case, emission computed tomography in the R-1 subtype single coronary artery proved that ischemia occurred in an area where the coronary artery was not visible to the naked eye. Meticulous follow-up would be crucial, because sudden death may occur in single coronary arteries. To prevent atherosclerosis with full efforts is also important, as the authors indicated admirably.
Core Tip: The incidence of coronary artery anomalies is as low as 1%-2% in the general population, even when the various types are combined. Among these, the R-1 subtype in a single coronary artery is extremely rare. In this case report by Zhou et al, emission computed tomography showed that ischemia occurred in an area where the coronary artery was not visible to the naked eye. Meticulous follow-up is crucial because sudden death may occur owing to a single coronary artery. Furthermore, atherosclerosis prevention is important because percutaneous coronary intervention could pose a high risk when necessary for such anomaly.
