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Journal of Case Reports
Anomalous Malignant Right Coronary Artery with Hypertrophic Cardiomyopathy: A Rare Anaesthesiologist’s Encounter in a Patient Posted for Non-cardiac Surgery
Sonali Banwait, Madhu Gupta, Anil Thakur, Parin Lalwani
Department of Anaesthesia, ESI Post Graduate Institute Medical Sciences and Research, Basaidarapur, Ring Road, New Delhi, India.
Corresponding Author:
Dr. Sonali Banwait
Email: sonalibanwait@gmail.com
Received: 25-FEB-2016 Accepted: 27-MAR-2016 Published Online: 20-MAY-2016
DOI: http://dx.doi.org/10.17659/01.2016.0053
Abstract
Anomalous coronary arteries and hypertrophic cardiomyopathy are the leading cause of sudden cardiac death in young individuals with a high rate of autopsy diagnosis. A 38 year old male with fracture left distal end of radius presented with history of occasional palpitations and a single syncopal attack. Transthoracic echocardiography showed non-obstructive hypertrophic cardiomyopathy while CT angiography revealed anomalous inter-arterial right coronary artery. The above findings categorized the patient as extremely high risk for perioperative major cardiac event. The team of perioperative physicians in communication with the patient reached a consensus for closed reduction of the fracture with referral to a cardiothoracic center for malignant right coronary. Diligent pre-anaesthestic evaluation and team based approach helped in diagnosis of this rare life threatening entity while ultrasound guided supraclavicular block proved critical for the patient in having a favorable outcome.
Keywords : Angiography, Coronary Vessels, Echocardiography, Hypertrophic Cardiomyopathy, Syncope.
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