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>Intravascular Ultrasound-Validated Mechanical Stress of the Aorta on Anomalous Origin of Coronary Artery ― A Possible Sign of Angina ―
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Intravascular Ultrasound-Validated Mechanical Stress of the Aorta on Anomalous Origin of Coronary Artery ― A Possible Sign of Angina ―
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机译：Intravascular Ultrasound-Validated Mechanical Stress of the Aorta on Anomalous Origin of Coronary Artery ― A Possible Sign of Angina ―
A 62-year-old Japanese woman with no remarkablemedical history was observed to have an abnormalECG at a medical examination. Although there wereno subjective symptoms, a treadmill exercise stress test showedmarked ST depression in leads II, III, aVF, and V2–V6.Exercise stress myocardial scintigraphy with 99mTc-tetrofosminconfirmed the findings of myocardial ischemia in theanterior walls of the left ventricle (Supplementary Figure).Coronary artery computed tomography revealed that theleft coronary artery (LCA) was branching from a slightlyhigher site of the noncoronary cusp, and the left maintrunk was bent at 90 degrees immediately after branching(Figure A,B). Cardiac catheterization was performed, andno severe stenosis was found. When observed by intravascularultrasound (IVUS), the LCA had a slit-like ostiumand was further deformed in the systolic phase (Figure C,D;Supplementary Movie). We determined that the cause ofangina was a hemodynamic problem associated with thecoronary artery anomaly and flexion deformation of thecoronary artery due in part to aortic pulsation.
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