Korean Circ J.  1998 Apr;28(4):576-585. 10.4070/kcj.1998.28.4.576.

Role of Transesophageal Echocardiography in Identifying Anomalous Origin and Course of Coronary Arteries

• Cha KS
• Kim HK
• Chun KJ
• Kim MH
• Kim YD
• Kim JS

• KMID: 2145713
• DOI: http://doi.org/10.4070/kcj.1998.28.4.576

Abstract

BACKGROUND
Anomalous origin of a coronary artery is rare, but it can lead to angina pectoris, acute myocardial infarction, or even sudden death in the absence of atherosclerosis. Even when an anomalous vessel is identified angiographically, it may be difficult to delineate its true course on the basis of angiography alone. We attempted to determine whether transesophageal echocardiography (TEE) is of value in making the diagnosis and outlining the course of anomalous left circumflex (LCx) or right coronary arteries (RCA). METHOD: Eight adult patients with anomalous origin of LCx or RCA documented by selective coronary angiography were studied by transthoracic echocardiography (TTE) and multiplane TEE.
RESULTS
Anomalous coronary ostia were visualized in all eight patients by TEE, but in only one with anomalous RCA out of eight patients by TTE. The proximal segments of anomalous coronary vessels were delineated in all eight patients by TEE and in only three with anomalous LCx out of eight patients by TTE.
CONCLUSION
TEE is a valuable adjunctive diagnostic tool for the identification of anomalous coronary origin and course and is superior to TTE in adult patients.

Keyword

Anomalous left circumflex coronary artery; Anomalous right coronary artery; Transesop-hageal echocardiography

MeSH Terms

Adult
Angina Pectoris
Angiography
Atherosclerosis
Coronary Angiography
Coronary Vessels*
Death, Sudden
Diagnosis
Echocardiography
Echocardiography, Transesophageal*
Humans
Myocardial Infarction