TITLE:
An unusual case of chest pain and dyspnea on exertion
AUTHORS:
Geetinder Goyal, Isabel Oliva, Pramod Bonde, Clemente Britto, Wassim H. Fares
KEYWORDS:
Congenital Coronary Anomaly; Exertional Dyspnea; Exertional Chest Pain
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.2 No.2,
May
9,
2013
ABSTRACT:
Congenital coronary artery anomalies occur in less than 1% of the
general population with clinical consequences ranging from benign incidental
findings to sudden cardiac death. More often than not this diagnosis is made on
a postmortem examination but up to one third of the patients have symptoms such as exertional chest pain and dyspnea.
Due to the correctable nature of this entity and the fact that anomalous
origins of coronary arteries can be readily diagnosed by noninvasive cardiac
imaging modalities, timely clinical suspicion based on symptoms is critical. We
present a case of a 37 years old with exertional chest pain and dyspnea of
several years duration who was found to have an anomalous origin of the left
main coronary artery. A surgical correction was undertaken which resulted in resolution of his symptoms. Our case highlights the importance of keeping congenital
coronary anomalies on the differential diagnosis for exertional chest pain
and dyspnea in young individuals and following inconclusive noninvasive
testing with more definitive diagnostic modalities.