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Anomalous origin of the main stem of the left coronary artery from the pulmonary trunk presenting with left ventricular hypertrophy

Published online by Cambridge University Press:  23 January 2007

Liat Gelernter-Yaniv  and
Avraham Lorber
Liat Gelernter-Yaniv
Affiliation:
Pediatric Cardiology Unit, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel
Avraham Lorber
Affiliation:
Pediatric Cardiology Unit, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel
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Abstract

Patients with anomalous origin of the left coronary artery from the pulmonary trunk may present with paroxysmal angina on exertion, congestive heart failure, dyspnoea, syncope or sudden death. The association of such anomalous origin of the left coronary artery from the pulmonary trunk with a hypertrophic left ventricle is extremely rare. In our cohort of patients with anomalous origin of the left coronary artery from the pulmonary trunk, two presented with a hypertrophic left ventricle. We discuss these cases, accompanied by a review of the English literature describing different morphological anomalies of the coronary arteries associated with left ventricular hypertrophy. Whether the hypertrophy is a result of the evolvement of the collateral coronary system, or due to an additional pathological gene for hypertrophic obstructive cardiomyopathy, remains an enigma. The hypertrophy may have served as a compensatory mechanism accounting for the atypical clinical presentation. We further discuss the possible factors associating the occurrence of anomalous origin of the left coronary artery from the pulmonary trunk and myohypertrophy, supported by the documentation of the regression of hypertrophy following surgical correction of the anomalous arterial origin as seen in our patients.

Keywords

Myohypertrophyanomalous coronary originhypertrophic obstructive cardiomyopathyischaemia
Type
Original Article
Information
Cardiology in the Young , Volume 17 , Issue 1 , February 2007 , pp. 78 - 83
Copyright
2007 Cambridge University Press

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