Key result
Cardiac catheterization successfully diagnoses left coronary artery ostial atresia despite falsely reassuring advanced imaging.
Why the study?
Advanced imaging techniques may fail to detect left coronary artery ostial atresia, necessitating alternative diagnostic approaches.
Case Report (n=1)
This case highlights the continued importance of invasive cardiac catheterization for diagnosing left coronary ostial atresia when advanced non-invasive imaging modalities are falsely reassuring.
Noninvasive imaging may miss coronary ostial atresia in pediatric exertional syncope; leaves open optimal diagnostic algorithms.
A 12-year-old boy with intermittent syncope associated with exercise. Exercise stress testing suggested myocardial ischemia and 2D echocardiography failed to confirm antegrade flow in the left main stem. Advanced imaging techniques including cardiac-gated computed tomography angiography and stress cardiac magnetic resonance imaging were falsely reassuring. Cardiac catheterization demonstrated left coronary artery ostial atresia with a good caliber left coronary system supplied by generous collaterals from the right coronary artery. The patient underwent successful coronary artery bypass grafting.
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Karayiannis et al. (2015) conducted a case report in Left coronary ostial atresia (n=1). Cardiac catheterization vs. Advanced imaging techniques (CT angiography and stress MRI) was evaluated. Cardiac catheterization successfully diagnosed left coronary artery ostial atresia in a 12-year-old boy after advanced imaging techniques were falsely reassuring.
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