Key result
Pericardial adhesions, HCM, and LV aneurysm cause rare dynamic coronary artery narrowing in 4 cases.
Why the study?
Phasic coronary artery narrowing occurring only in systole or diastole is unusual and its diagnostic and pathophysiologic characteristics require clarification.
Case Report (n=4)
Highlights rare mechanical causes of phasic coronary artery compression during systole or diastole.
Phasic coronary narrowing may warrant evaluation for pericardial or myocardial causes; leaves open the prevalence and clinical relevance of these mechanisms.
Four unusual cases of phasic (occurring only in systole or only in diastole) coronary artery narrowing are reported. In two cases, diastolic compression of the left anterior descending coronary artery was due to tight pericardial adhesions in patients with aortic insufficiency; in the third case, systolic compression of two right ventricular coronary branches was associated with hypertrophic cardiomyopathy and a normotensive right ventricle; and in the fourth case, a large aneurysm of the inferior wall of the left ventricle caused systolic compression of the posterior descending coronary artery, which was epicardial. The diagnostic and pathophysiologic characteristics of each case are discussed.
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Angelini et al. (1986) conducted a case report in Atypical phasic coronary artery narrowing (n=4). Atypical phasic coronary artery narrowing was evaluated. Four unusual cases of phasic coronary artery narrowing were identified, caused by pericardial adhesions, hypertrophic cardiomyopathy, and a left ventricular aneurysm.
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