"Sawfish" systolic narrowing of the left anterior descending coronary artery: an angiographic sign of hypertrophic cardiomyopathy.
Population
14 patients with systolic narrowing of the left anterior descending coronary artery evaluated by coronary…
Comparison
Evaluation of morphologic characteristics at… vs Patients with isolated systolic narrowing vs…
Design
Case_series
Authors
Discussion
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Implication
Saw-fish' LAD narrowing may aid HCM recognition on angiography; case report leaves open diagnostic specificity and need for validation.
Key Points
- To evaluate and characterize the angiographic morphology of systolic narrowing in the left anterior descending coronary artery in patients with and without hypertrophic cardiomyopathy.
- Evaluated coronary arteriography findings in 14 patients presenting with systolic narrowing of the left anterior descending coronary artery (LAD).
- Compared 6 patients with isolated LAD systolic narrowing and no other cardiac abnormalities (group A) against 8 patients with LAD systolic narrowing accompanied by hypertrophic cardiomyopathy (group B).
- Patients with isolated systolic narrowing (group A) showed smooth, progressive vessel constriction culminating in a rat-tail appearance, with no narrowing in septal branches or other epicardial vessels.
- Patients with hypertrophic cardiomyopathy (group B) exhibited a sawfish appearance of LAD narrowing, accompanied by systolic narrowing of septal branches in 7 of 8 patients and other epicardial vessels in 5 of 8 patients.
Structured PICO
P
Population
14 patients with systolic narrowing of the left anterior descending coronary artery (LAD) evaluated by coronary arteriography, including 6 without other cardiac abnormalities and 8 with hypertrophic cardiomyopathy.
I
Intervention
Evaluation of morphologic characteristics at coronary arteriography
C
Comparator
Patients with isolated systolic narrowing (Group A) vs. patients with hypertrophic cardiomyopathy (Group B)
O
Outcome
Morphologic appearance of systolic narrowing of the LADsurrogate
A 'saw-fish' appearance of systolic LAD narrowing on coronary angiography is a distinct morphologic sign associated with hypertrophic cardiomyopathy, differentiating it from a simple myocardial bridge.
Cite This Study
Brugada et al. (1982) studied this question.