<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction:</bold> We present the case of a young man with multiple atherosclerotic risk factors and a rare cause of angina and supraventricular ectopic beats.<bold>Case presentation:</bold> A 35-year-old man with one-year history of stable angina pectoris and supraventricular ectopic beats, without any medication, presented to the emergency room complaining of anterior chest pain that occurs at moderate physical exertion. The rest electrocardiogram, transthoracic echocardiography, and chest X-ray were normal; the exertion stress test was also normal, except for supraventricular ectopic beats (trigeminal rhythm). Due to the intermediate pre-test probability of coronary artery disease, he was evaluated using coronary computed tomography angiography. An anomalous origin of the right coronary artery from the left coronary sinus, with an inter-arterial course and without any atheroma plaques, was observed. During hospitalization the evolution was stable, without complications. The patient was further referred to a cardiac surgery clinic to evaluate the possibility of surgical treatment of this anomaly.<bold>Conclusions:</bold> Coronary artery anomalies are very rare; however, they present multiple implications in current practice. The most severe complication of this condition is represented by sudden death in young patients due to malignant ventricular arrhythmias. Imaging diagnostic techniques allow for a rapid, noninvasive diagnosis of this rare cause of angina.</abstract>

Introduction: We present the case of a young man with multiple atherosclerotic risk factors and a rare cause of angina and supraventricular ectopic beats.Case presentation: A 35-year-old man with one-year history of stable angina pectoris and supraventricular ectopic beats, without any medication, presented to the emergency room complaining of anterior chest pain that occurs at moderate physical exertion. The rest electrocardiogram, transthoracic echocardiography, and chest X-ray were normal; the exertion stress test was also normal, except for supraventricular ectopic beats (trigeminal rhythm). Due to the intermediate pre-test probability of coronary artery disease, he was evaluated using coronary computed tomography angiography. An anomalous origin of the right coronary artery from the left coronary sinus, with an inter-arterial course and without any atheroma plaques, was observed. During hospitalization the evolution was stable, without complications. The patient was further referred to a cardiac surgery clinic to evaluate the possibility of surgical treatment of this anomaly.Conclusions: Coronary artery anomalies are very rare; however, they present multiple implications in current practice. The most severe complication of this condition is represented by sudden death in young patients due to malignant ventricular arrhythmias. Imaging diagnostic techniques allow for a rapid, noninvasive diagnosis of this rare cause of angina.

A Rare Cause of Supraventricular Ectopic Beats and Angina in a Young Patient

“Sf. Spiridon” Clinical Emergency Hospital

“Grigore T. Popa” University of Medicine and Pharmacy

Journal of Cardiovascular Emergencies

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"A Rare Cause of Supraventricular Ectopic Beats and Angina in a Young Patient"}

Introduction: We present the case of a young man with multiple atherosclerotic risk factors and a rare cause of angina and supraventricular ectopic beats.Case...

A Rare Cause of Supraventricular Ectopic Beats and Angina in a Young Patient

Published Online: Jul 17, 2018

Page range: 106 - 109

Received: May 02, 2018

Accepted: Jun 05, 2018

DOI: https://doi.org/10.2478/jce-2018-0010

Keywords
anomalous coronary origin, right coronary artery, inter-arterial course

© 2018 Monica Jurcău et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

A Rare Cause of Supraventricular Ectopic Beats and Angina in a Young Patient

Published Online: Jul 17, 2018

Page range: 106 - 109

Received: May 02, 2018

Accepted: Jun 05, 2018

DOI: https://doi.org/10.2478/jce-2018-0010

Keywordsanomalous coronary origin, right coronary artery, inter-arterial course

© 2018 Monica Jurcău et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
anomalous coronary origin, right coronary artery, inter-arterial course