Author + information
Patient initials or identifier number
Relevant clinical history and physical exam
Mr. A.A. 61 years old, a hypertensive, non-smoker and diabetic man admitted to intervention cardiology department with the complaints of dyspnea and chest pain that spreads to the left arm in the in exertion, weakness and periodically elevation of blood pressure.
On physical examination:
Pulse: 72/ min
BP: 120/80 mmHg
RR: 18/ min
Heart: No added sound
Lungs: No added sound
JVP: Not Raise
Other System: NAD
Relevant test results prior to catheterization
ECG: Metabolic changes in myocardium
Echo: Sclerosis of the aorta wall, centralhemodynamics is normal
Relevant catheterization findings
Left main coronary artery is large, departs from the right sinus of the ascending aorta. LAD presented vessel large caliber traveled all over with smooth contours. Circumflex branch represented by medium-caliber vessel traveled all over; in the distal segment is marked stenosis up to 80%. RCA large caliber, in the middle segment, is marked on the verge of a critical stenosis of occlusion. The right type of coronary circulation.
After processing the surgical field and anesthesia, the distal radial artery segment 2.0% lidocaine 4 ml puncture made radial artery (D) at the first attempt. In the lumen of the artery set introducer 6F 110. Through the introducer with the diagnostic hydrophilic conductor, p 0.035 x 150 cm into the aorta introduced Diagnostic Catheter JL 4.0 cm 6F and selectively catheterize the left main coronary artery. Performed left coronarography in 5 projections.
Right coronarography. Through the introducer with the diagnostic catheter, JR 4.0 cm 6F selectively catheterized the right main coronary artery. Performed right coronarography in two projections
This is a rare case in coronary angiography diagnostics since the left maincoronary artery departs from the right sinus of the ascending aorta.