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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">An anomalous aortic origin of the coronary arteries is rare&#44; with a reported incidence of 0&#46;3&#8211;1&#46;3&#37;&#46; An anomalous left coronary artery from the right sinus with an interarterial course has a prevalence of 0&#46;17&#37; and is associated with a high risk of sudden cardiac death during or after strenuous exertion&#46; We present the case of a 45-year-old woman with no relevant medical history referred for cardiology consultation due to tachycardia&#46; She reported no other relevant cardiovascular symptoms&#44; including fatigue&#44; dyspnea&#44; dizziness or syncope&#46; Initial examination including electrocardiogram&#44; laboratory tests including thyroid function&#44; echocardiography and 24-hour Holter revealed no significant changes&#46; She performed a treadmill exercise test &#40;7 min 30 s with the Bruce protocol&#41;&#44; reaching the maximum predicted heart rate with no angina or arrhythmias&#44; but with ST-segment depression of 1&#46;5 mm in the inferior leads&#46; Given the low likelihood of coronary artery disease&#44; a cardiac computed tomography scan was requested to rule it out&#44; which revealed an anomalous origin of the left coronary artery from the right sinus of Valsalva &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figures 1 and 2</a>&#41; with interarterial course between the aorta and the pulmonary artery &#40;<a class="elsevierStyleCrossRefs" href="#fig0015">Figures 3 and 4</a>&#41;&#46; Her calcium score was 0&#46; Although there is still disagreement on the subject&#44; the AHA&#47;ACC guidelines recommend surgical coronary revascularization in patients with anomalous left coronary artery arising from the right sinus of Valsalva and coursing between the aorta and pulmonary artery &#40;class I recommendation&#44; level of evidence B&#41;&#46; After discussion with the patient&#44; the case was referred to our cardiac surgery center&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0010" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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Image in Cardiology
A rare cause of tachycardia
Causa rara de taquicardia
Raquel Ferreira
Corresponding author
ana_rakel_ferreira@hotmail.com

Corresponding author.
, Anabela Gonzaga, Pedro Cardoso, José Bastos, José António Santos
Serviço de Cardiologia do Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">An anomalous aortic origin of the coronary arteries is rare&#44; with a reported incidence of 0&#46;3&#8211;1&#46;3&#37;&#46; An anomalous left coronary artery from the right sinus with an interarterial course has a prevalence of 0&#46;17&#37; and is associated with a high risk of sudden cardiac death during or after strenuous exertion&#46; We present the case of a 45-year-old woman with no relevant medical history referred for cardiology consultation due to tachycardia&#46; She reported no other relevant cardiovascular symptoms&#44; including fatigue&#44; dyspnea&#44; dizziness or syncope&#46; Initial examination including electrocardiogram&#44; laboratory tests including thyroid function&#44; echocardiography and 24-hour Holter revealed no significant changes&#46; She performed a treadmill exercise test &#40;7 min 30 s with the Bruce protocol&#41;&#44; reaching the maximum predicted heart rate with no angina or arrhythmias&#44; but with ST-segment depression of 1&#46;5 mm in the inferior leads&#46; Given the low likelihood of coronary artery disease&#44; a cardiac computed tomography scan was requested to rule it out&#44; which revealed an anomalous origin of the left coronary artery from the right sinus of Valsalva &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figures 1 and 2</a>&#41; with interarterial course between the aorta and the pulmonary artery &#40;<a class="elsevierStyleCrossRefs" href="#fig0015">Figures 3 and 4</a>&#41;&#46; Her calcium score was 0&#46; Although there is still disagreement on the subject&#44; the AHA&#47;ACC guidelines recommend surgical coronary revascularization in patients with anomalous left coronary artery arising from the right sinus of Valsalva and coursing between the aorta and pulmonary artery &#40;class I recommendation&#44; level of evidence B&#41;&#46; After discussion with the patient&#44; the case was referred to our cardiac surgery center&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0010" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Left and right coronary arteries with a common origin in the right sinus of Valsalva&#46; Cx&#58; circumflex&#59; LAD&#58; left anterior descending&#59; LM&#58; left main&#59; PDA&#58; posterior descending artery&#59; RCA&#58; right coronary artery&#46;</p>"
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Article information
ISSN: 21742049
Original language: English
DOI:10.1016/j.repce.2014.08.024
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