Evaluating the Prevalence of Non-Ischemic and Ischemic Coronary Artery Anomalies Using Multi Slice CT Angiography 384 in Shahid Rajaee Hospital in 2016 and 2017
Author(s): Maryam Ghasemi, MarziehMotavali, Ali Mohammadzadeh
Given high prevalence of coronary artery diseases and multiple risk factors involved in these diseases, we decided to evaluate the less common but influential causes of these diseases. This study is a descriptive cross-sectional study. In this study, we examined 10413 patients, admitted to Shahid Rajaee Hospital from July 2016 to July 2017 and underwent coronary artery CT angiography by using census method. Only 72 patients were admitted due to coronary artery diseases, and the rest of the patients underwent CT angiography due to atherosclerotic diseases of the coronary arteries. In our research, non-atherosclerotic heart diseases were classified into five general groups in terms of disease prevalence: 36.1% of patients had coronary artery anomaly, 29.2% had congenital coronary artery fistula, 5.6% had post-operative coronary artery fistula, 19.4% congenital heart disease, 6.9% had Kawasaki and 2.8% had vasculitis. The most common type of congenital coronary anomaly was an anomaly with opposite crusp origin and the most common involved arteries were left circumflex arteries and right coronary arteries. The coronary artery fistula was the next disease. The most common arteries, as anomaly, were right coronary artery and left circumflex artery, and the most common site of fistulization was reported in right ventricle, pulmonary artery, and left atrium. The next non-atherosclerotic disease was congenital heart disease, which was associated with coronary artery anomalies in 78.5% of cases. The most common congenital heart disease in our study was ventricular septal defect, associated with coronary artery anomalies in right coronary artery in 83% of cases. The fourth disease was Kawasaki, associated with coronary artery aneurysm in 40% of patients. The next non-atherosclerotic disease was vasculitis, which involved the ascending aorta and coronary artery and caused symptoms. Non-atherosclerotic coronary artery disease is an uncommon disease, accounting for less than 1% of the patients admitted due to heart disease symptoms and causing sudden deaths at lower ages. These diseases should be considered in younger patients with heart disease symptoms. Coronary artery anomalies should be also examined in patients with congenital heart disease, since they are significantly correlated. Coronary artery aneurysm should be also considered in patients with Kawasaki infected at their childhood and adolescence.