Introduction Anomalous origin of the left circumflex coronary artery (LCx) from the right pulmonary artery (PA) is an extremely rare coronary anomaly. Although the clinical course may be silent, the risk of sudden cardiac death is increased. The symptoms are related to collateralization and amount of myocardium that it supplies, and some patients need surgical treatment., […]

A 54-year-old male patient, who was a smoker, was admitted to the emergency room with acute chest pain and dyspnea. Investigation was initiated by means of computed tomography angiography of the chest, which showed extensive dissection of the thoracic aorta, beginning in the ascending segment (Stanford type A), associated with intramural hematoma of the pulmonary artery trunk and its main branches. It was more evident on the right, which determines local pulmonary luminal reduction, in addition to a small para-aortic […]

Complementary examinations Electrocardiogram: Sinus rhythm, signs of right cavity overload, with apiculate P wave + 70º, QRS complex showing predominance of S waves from V4 to V6 and axis deviated to the right (AQRS= +110°). The T wave was negative in the precordial leads with diffuse ventricular repolarization changes in all other leads ( ). […]

Abstract Fistula from left internal mammary artery (LIMA) to pulmonary artery (PA) is rarely encountered in daily practice. In recent years, endovascular therapy options have emerged for the treatment of fistula formations and replaced with surgery. A 53-year-old man admitted to our outpatient clinic with symptoms of typical angina and shortness of breath despite optimal medical therapy. In his relevant history, he had a coronary artery bypass graft (CABG) operation in 2009 in which his LIMA was anastomosed to left […]