Anomalous LCA ???

[impalass]

Hi! I'm 47 years old army retiree. Never have heart problems other than hagh blood pressure. I have a MI on January. They install 3 stents on my RCA. During the angioplasty they found that I have a anomality on my LCA which origin from the right coronary artery and course between my AA % PA. It have a 20% dynamic compression. This anomality never gave me any trouble during exercise. The only pain I ever have was during my MI. After the implants I start complaining about chest pain. It last about 1-3 seconds. Is a stabbing pain and sometimes like a burning sensation. It all over my chest, neck, arms. I went to my doctor and he said is Costocondritis. My questions are as follows: 1- Where I can find information on my anomality?. My doctor told me that is very rare. 2- How they fixed? 3-% mortality rate. 4- Where I can find a Doctor with experience on cases like mine. I Have look in the internet and i can't find anything about this rare anomality. I'm also epileptic with grand mal seizure and every time I have a seizure my heart puonds like crazy. In addition latetly i feel my heart skip a beat. I went to the ER and they told me it was normal. Can you answer my question and give some direction?

[Cleveland Clinic]

impalass,

thanks for the post.

1- Where I can find information on my anomality?

There isnt alot of information in the general net because not alot is known about the true incidence and there is even some debate over the anatomy using conventional angiography techniques.  The combination of newer and non invasive imaging modalities with what is known should help expand this information in the future.  Probably overall the best place for you to find out more would be in a medical library and using medical search engines such as

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

and standard text books on the subject.  


2- How they fixed?

Some require no intervention some are higher risk and involve bypass or surgical modification.  There are features of each type of anomaly that deterimine the therapy.  From the information you provide, a course between the PA and aorta would generally require evaluation for true anatomy and possible repair.

3-% mortality rate?

Each varies based on age, other conditions and the anomaly.  I can't tell you exact numbers.

4- Where I can find a Doctor with experience on cases like mine.

You should see someone at a tertiary referal center.  The physicians at these centers treat more and are more experienced in handling these types of cases.

5- Can you answer my question and give some direction?


Hopefully I've given you a start.

good luck

[impalass]

Hi! it's me again. Thanks for the answer.I probably don't need surgery. I pass all my tests. My mother had valve replacement surgery and it was done off-pump. Can a surgery like mine could be done off-pump? I'm concern about the extra complications. I'm reading my records and it said the following; Anomalous origin of the left main artery from the right cusp. The main arouse anomalously from the right coronary artery and possibly coursed anterior to the aorta and pulmonary artery. here was a discrete 20% dynamic compression in the intra arterial segment at the promal third of the vessel. Left main was difficult to engage. Best images were obtained using 6F JR4. Advice patient for further imaging and posible surgery. I have 2 Perfusion tests done in less than 5 months and only one reflect my MI. Thanks for your answer. I guess the only thing is to pray for hope.