Muhammad Nawaz Lashari, Tariq Ashraf, Asadullah Kundi.
High risk coronary artery anomalies in 5131 adult patients undergoing coronary Arteriography at NICVD Karachi.
Pak J Cardiol Jan ;17(1):36-40.

Objective: To evaluate the frequency, origin, course and clinical significance of coronary anomalies. Design: Single centre, descriptive study. Place & Duration of Study: The study was carried out at National Institute of Cardiovascular Diseases, (NICVD) Karachi, from January 2003 to July 2004. Methods: All adult patients (n=5131) undergone during study period for coronary arteriography included. Coronary arteriograms were evaluated for coronary anomalies by author. Patients with low risk coronary anomalies were excluded from study. Result: Seventy two percent were males and 28% females; the mean age of patients was 54 years with a range of 26 years to 70 years. Fifty five percent were present with chestpain,33.3% with shortness of breath and 11.1 % with palpitation. Total frequency was seen in 0.35% ; out of them 88.8% have anomalous origin and distribution while 11.11 % have coronary artery fistula. Left circumflex, LAD, left main coronary artery arise from right sinus of valsalva with frequency of 0.155, 0.058 and 0.058% respectively. In 0.058% of patients RCA arise from left sinus while 0.038% patients LAD arise from non coronary sinus. Coronary fistula noted in 0.038% patients. Conclusion: Clinicians, cardiologists and cardiac surgeons may consider coronary anomalies to be interesting rarities. The proper recognition determine the proper course of action for their management.

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