Chronic Ischemia Induced by Woven Coronary Artery Anomaly with Typical Atrial Flutter: Insights from Multiple Imaging Devices

Akio Chikata, Satoru Sakagami, Naomi Kanamori, Chieko Kato, Wataru Omi, Takahiro Saeki, Hideo Nagai, Soichiro Usui, Kenichi Nakajima, Masayuki Takamura
2015 Internal medicine (Tokyo. 1992)  
A 75-year-old man with a 120-bpm tachycardia and typical atrial flutter was admitted. Echocardiography showed a dilated left ventricle with anterior and apical wall akinesia. Tachycardia was terminated with cavotricuspid isthmus ablation. Multiple imaging findings revealed a woven coronary artery anomaly (WCAA) in the left anterior descending artery. Stress myocardial perfusion imaging was performed after ablation in the sinus rhythm and revealed stress-induced ischemia and a fixed low uptake
more » ... fixed low uptake in the WCAA territory. WCAA is generally regarded as a benign condition; however, compromised blood flow within the anomaly, caused by tachycardia-related diastolic shortening, may induce ischemia.
doi:10.2169/internalmedicine.54.4333 pmid:26328644 fatcat:bk747yzaqnc65ol47rjef2b24y