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Left main coronary artery atresia in a child: a case report and review of the literature

Published online by Cambridge University Press:  03 August 2017

Tomohiro Hayashi ,
Kenji Waki  and
Yoshio Arakaki
Tomohiro Hayashi*
Affiliation:
Department of Pediatrics, Kurashiki Central Hospital, Kurashiki, Japan
Kenji Waki
Affiliation:
Department of Pediatrics, Kurashiki Central Hospital, Kurashiki, Japan
Yoshio Arakaki
Affiliation:
Department of Pediatrics, Kurashiki Central Hospital, Kurashiki, Japan
*
Correspondence to: T. Hayashi, Department of Pediatrics, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan. Tel: +8 186 422 0210; Fax: +8 186 421 3424; E-mail: th11884@kchnet.or.jp
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Abstract

Congenital atresia of the left coronary artery is a very rare condition. We report a case of a 13-year-old boy who was followed-up at our outpatient clinic from 6 months of age because of heart murmur. He had no symptoms for more than 10 years, and his left ventricular contraction was normal. Exercise electrocardiogram was performed at 7 and 10 years of age, and ST depression was not observed. He presented with chest pain and syncope on exertion at the ages of 11 and 12 years, respectively, and ST depression on exercise electrocardiogram was detected for the first time at 13 years of age. Cardiac echocardiography showed a high-choic antero-lateral papillary muscle of the mitral valve, prolapse of the mitral anterior leaflet, and mild mitral valve regurgitation. Coronary angiography did not demonstrate antegrade left coronary flow or dilation of the right coronary artery. We performed coronary artery bypass grafting using the left internal thoracic artery. Postoperatively, the ST depression resolved, and his exercise tolerability improved.

Keywords

Syncopeischaemiacoronary artery bypass graftingexercise electrocardiogram
Type
Brief Report
Information
Cardiology in the Young , Volume 27 , Issue 9 , November 2017 , pp. 1841 - 1844
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Copyright
© Cambridge University Press 2017 

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