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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report on a man without any symptoms until the age of 29 years when a ventricular tachyarrhythmia occurred for the first time. There were electrocardiographic signs of a previous myocardial infarction of the anterior wall, but there had not even been any episode of angina pectoris. The cause was the anomalous origin of the left coronary artery from the pulmonary trunk (Bland-White-Garland syndrome). Therapy consisted of ligation of the left coronary artery and the implantation of an aortocoronary vein graft to the left coronary artery in order to reinstall a two-coronary system. Diagnosis is easily made by coronary angiography. At a 3-year follow-up there was an increase of the ejection fraction/cardiac output, a stable sinus rhythm, and an improved physical endurance.
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PMID:[Anomalous origin of the left coronary artery from the pulmonary artery (Bland-White-Garland syndrome) in a 29-year-old male with absolute tachyarrhythmia]. 172 79

A 39-year-old woman, with known mild mitral regurgitation, developed progressively more severe symptoms of angina, associated with an ischaemia response in the exercise electrocardiogram. Angiocardiography demonstrated an anomalous origin of the left coronary artery from the pulmonary artery (Bland-White-Garland syndrome). At operation an aortocoronary venous bypass graft was constructed; the patient has been without symptoms since and the exercise ECG is normal. As demonstrated by angiography, the previously marked dilatation of the right coronary artery had largely regressed and previously present collaterals to the left coronary artery were no longer visualized three months after operation. The described coronary artery anomaly, although rare, should be considered in a young patient with reproducible coronary artery ischaemia.
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PMID:[Ischemic reaction in a young woman without coronary sclerosis: Bland-White-Garland syndrome]. 259 92

A review of 1097 consecutive coronary angiograms performed for evaluation of angina pectoris or valvular dysfunctions showed 3 patients with arteriovenous fistulas (0.25%), 6 patients with malpositions (0.55%), 29 patients with aneurysms (2.65%) and 59 patients with myocardial bridging (5.4%). The clinical significance of coronary artery anomalies as variation or malformation was evaluated. A malformation has been found in Bland-White-Garland syndrome, arteriovenous fistulas, congenital coronary stenosis and atresia. In case of clinical symptoms surgical correction should be considered. There is a controversy on the clinical significance of muscular bridging. Further clinical investigations are needed for a better understanding of coronary artery anomalies.
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PMID:[Coronary vessel anomalies in adults--harmless variation or changes with clinical significance]. 846 48

An anomalous origin of the left coronary artery from the pulmonary artery (Bland-White-Garland syndrome) was diagnosed in a 31-year-old woman complaining of angina at 10 weeks of gestation. After termination of pregnancy, the patient underwent surgical repair with ligation of the left coronary artery at the ostium, and a single bypass graft with a left internal thoracic artery to the left anterior descending coronary artery. Angiography, performed at 6 months of follow-up, showed stenosis of the distal anastomosis of the graft that was treated with angioplasty and deployment of a paclitaxel-eluting stent. After 9 months the patient was symptom-free and angiography excluded in-stent restenosis. Experience with the surgical repair of the anomaly is limited by the rarity of this condition; in particular, it has never been reported as a first diagnosis during pregnancy. In the discussion, we analyze the efficacy and limits of the different current strategies for the surgical repair of this rare, but potentially life-threatening, congenital coronary anomaly.
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PMID:Anomalous origin of the left coronary artery from the pulmonary artery in an adult pregnant patient: surgical and percutaneous myocardial revascularization. 1590 36

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that is often referred to as Bland-White-Garland syndrome. Isolated anomalous origin of the left anterior descending (LAD) or circumflex arteries is even rarer. A 38-year-old woman presented with typical angina of about two-year history. Physical examination findings were normal other than a grade 3/6 systolic murmur. Electrocardiography showed anterolateral ST-segment depression and T wave inversion, indicating anterior ischemia. Color flow transthoracic Doppler echocardiography showed dilated coronary arteries. Parasternal short axis views demonstrated an abnormal flow originating from the common pulmonary artery. Upon suspicion of a coronary anomaly, coronary angiography was performed. Both the left circumflex (Cx) and right coronary arteries (RCA) were found dilated, giving extensive collaterals to the LAD artery, which drained into the main pulmonary artery. Computed tomographic angiography confirmed that the LAD artery originated from the main pulmonary artery. Surgical correction was performed and the LAD artery was re-anastomosed to the aorta. Control coronary angiography performed one week after surgery showed patent LAD artery and diminished collateral supply from the RCA and Cx arteries.
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PMID:Left anterior descending coronary artery originating from the pulmonary artery: a rarity suspected during echocardiography. 1862 12