Anomolous Right Coronary Artery Question

"grey area" is the term cardiologist frequently use referring to my condition. A congenital heart murmur and anomolous right coronary artery (pinched between my aorta and pulmonary artery, attached to the bottom left side of my heart.

Discovered in '00 (52 years young at the time) was told I had a "runner's heart" and yes, I could keel over immediately. Right mammary artery CABG was discovered to be totally occluded after 6 months.

The fatigue, breathlessness, chest flutters, hot flushed face symptoms are ever increasing, yet one cardiologist doesn't think they are related to my heart at all. The first surgeon says I have a 20% chance of keeling over and wants to do another surgery.

Echocardiogram says average LV EF%  by Simpson's Bi-Lane method =60-65%...have no idea what that means.

Would like to be an active Gramma, but have fears of "keeling" over...any suggestions or input?

[kenkeith]

The RCA is congenitally deformed (anomaly) and has limited space at a particular segment between aorta and pulmonary vessels to pass blood flow to the heart's right side. A deficit of blood flow to that area could cause right-side heart failure causing less than normal blood flow to the lungs for oxygenation and thereby reducing blood/oxygen to the circulation system.  If the cardiac output is low, that could cause your symptoms.  Worst case scenario if it is heart related.

An EF60-65% is the amount of blood in the left ventricle chamber that is pumped into circulation with each heartbeat....normal is 50 to 70%. You have strong heart contractions!  An advanced right-side heart failure will/could eventually cause the left-side to fail and your EF would go to below 29%

We all could keel over at any time,so its not very productive to think in those terms.

[JanisLee]

Thank you for your response...I agree it's not productive to think in terms of "keeling" over...

My other post asked about this taken from the CT Angiogram: 1. Anomalous origin or the right coronary artery, coursing between the ascending aorta and the pulmonary outflow tract, the "lethal Variant" with between 50 and 75% narrowing of its proximal segment....

Doesn't that mean possibly only 25% is coursing through....? Is that what you were referring to in your first paragraph?

We're tending to think the surgeon may be trying to buy a new Porsche for Christmas or something...I guess I shouldn't joke that way.

I WOULD like to know what's causing the fatigue, flushing, fluttering and breathlessness.

I've had a "feeling" my body was shutting down on a number of occasions. BP can go down to 85/35...which may indicate a very healthy heart, too!

If this helps with anyone explaining "my" questions, I've developed an acute hypersensitivity to medications over the last 10 years...can't tolerate about 40+ RX's right now, leading to 2 bouts of acute pancreatitis (no, I'm not a drinker, nor smoker for that fact) that doctors have attributed to medications taken.

I even had problems being pre-medicated for the recent CT Angiogram as I'm allergic to both the contrast and nitroglycerin.

I guess I'm rambling. Thanks again for your post.

[kenkeith]

Yes, I am referring to the possible complications if there is a serious deficit of blood flow to the heart's right side from the stenosis of the RCA. I  believe the report indicates there is a narrowing of the RCA at the location cited.  It is plausible the stenosis is 50 to 75% of the normal size....occlusions from plaque can often block and easily have that degree of blockage without any symptoms, and the usual protocol with a lesion greater than 70% is a stent if there is chest pain, etc. and if mediction (medication) does not relieve symptoms.