Sick sinus syndrome in a patient with single coronary artery anomaly

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Abstract

Single coronary artery anomaly is very rare. The reported manifestations include angina pectoris and congestive heart failure. Here we describe a case of single coronary artery anomaly presenting as sick sinus syndrome, which has no literature precedence. A 47-year-old woman had complained of intermittent dizziness for years. A Holter electrocardiogram showed sinus bradycardia and junctional or ventricular rhythm with a maximal ventricular pause of up to 3.2 seconds. Electrophysiologic study revealed prolonged corrected sinus nodal recovery time. Coronary angiography showed that the left anterior descending artery had a long course with a side branch originating from the proximal part and coursing anteriorly to the territory of the proximal portion of the right coronary artery. The sinus node is usually supplied by the sinoatrial branch via the fight coronary artery. Aortography showed that the right coronary artery ostium was absent. A permanent pacemaker was implantated and the patient was discharged in good condition. The present case suggests that coronary artery anomaly may lead to compromised blood supply to the sinus node, and hence sick sinus syndrome.

Original languageEnglish
Pages (from-to)785-788
Number of pages4
JournalJournal of the Formosan Medical Association
Volume99
Issue number10
Publication statusPublished - 2000 Nov 13

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Sick Sinus Syndrome
Coronary Vessels
Sinoatrial Node
Aortography
Angina Pectoris
Dizziness
Bradycardia
Coronary Angiography
Electrocardiography
Heart Failure
Arteries

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Sick sinus syndrome in a patient with single coronary artery anomaly",
abstract = "Single coronary artery anomaly is very rare. The reported manifestations include angina pectoris and congestive heart failure. Here we describe a case of single coronary artery anomaly presenting as sick sinus syndrome, which has no literature precedence. A 47-year-old woman had complained of intermittent dizziness for years. A Holter electrocardiogram showed sinus bradycardia and junctional or ventricular rhythm with a maximal ventricular pause of up to 3.2 seconds. Electrophysiologic study revealed prolonged corrected sinus nodal recovery time. Coronary angiography showed that the left anterior descending artery had a long course with a side branch originating from the proximal part and coursing anteriorly to the territory of the proximal portion of the right coronary artery. The sinus node is usually supplied by the sinoatrial branch via the fight coronary artery. Aortography showed that the right coronary artery ostium was absent. A permanent pacemaker was implantated and the patient was discharged in good condition. The present case suggests that coronary artery anomaly may lead to compromised blood supply to the sinus node, and hence sick sinus syndrome.",
author = "Ping-Yen Liu and Ting-Hsing Chao and Wei-Chuan Tsai and Yi-Heng Li and Liang-Miin Tsai and Chen, {J. H.}",
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T1 - Sick sinus syndrome in a patient with single coronary artery anomaly

AU - Liu, Ping-Yen

AU - Chao, Ting-Hsing

AU - Tsai, Wei-Chuan

AU - Li, Yi-Heng

AU - Tsai, Liang-Miin

AU - Chen, J. H.

PY - 2000/11/13

Y1 - 2000/11/13

N2 - Single coronary artery anomaly is very rare. The reported manifestations include angina pectoris and congestive heart failure. Here we describe a case of single coronary artery anomaly presenting as sick sinus syndrome, which has no literature precedence. A 47-year-old woman had complained of intermittent dizziness for years. A Holter electrocardiogram showed sinus bradycardia and junctional or ventricular rhythm with a maximal ventricular pause of up to 3.2 seconds. Electrophysiologic study revealed prolonged corrected sinus nodal recovery time. Coronary angiography showed that the left anterior descending artery had a long course with a side branch originating from the proximal part and coursing anteriorly to the territory of the proximal portion of the right coronary artery. The sinus node is usually supplied by the sinoatrial branch via the fight coronary artery. Aortography showed that the right coronary artery ostium was absent. A permanent pacemaker was implantated and the patient was discharged in good condition. The present case suggests that coronary artery anomaly may lead to compromised blood supply to the sinus node, and hence sick sinus syndrome.

AB - Single coronary artery anomaly is very rare. The reported manifestations include angina pectoris and congestive heart failure. Here we describe a case of single coronary artery anomaly presenting as sick sinus syndrome, which has no literature precedence. A 47-year-old woman had complained of intermittent dizziness for years. A Holter electrocardiogram showed sinus bradycardia and junctional or ventricular rhythm with a maximal ventricular pause of up to 3.2 seconds. Electrophysiologic study revealed prolonged corrected sinus nodal recovery time. Coronary angiography showed that the left anterior descending artery had a long course with a side branch originating from the proximal part and coursing anteriorly to the territory of the proximal portion of the right coronary artery. The sinus node is usually supplied by the sinoatrial branch via the fight coronary artery. Aortography showed that the right coronary artery ostium was absent. A permanent pacemaker was implantated and the patient was discharged in good condition. The present case suggests that coronary artery anomaly may lead to compromised blood supply to the sinus node, and hence sick sinus syndrome.

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