As you may know, the aortic valve has three cusps, two of which are coronary cusps, with the third being a non-coronary cusp (not a very inventive name).
Those in the cath lab know this from ACC database…
The one that seems most common is the first example…
Anomalous origin from PA is a congenital defect that can have a mortality rate of 90% in the first year of life, due to MI or MR leading to CHF- prognosis improves with early detection by echo and improved surgical techniques…(emedicine.medscape.com)
Knowledge of myocardial blood supply comes in handy when interpreting an ECG…
Especially in an acute MI situation, knowing which artery is having the infarct can give you an idea of the amount of heart muscle involved, which can be a large factor in the patient’s prognosis…
An IABP inflates during diastole, which will push more blood down the coronaries when the LV has been damaged…
We use NTG intracoronary to get a truer size of the vessel, and also to relieve any spasm that may be present..Injecting IIbIIIa inhibitors can be especially helpful with acute MI, when there is visible clot present in the vessel…not FDA approved.
How do we find as many of these people as possible before the MI happens?
So, what are the options for a patient with significant CAD?
MasonSones, Cleveland Clinic, catheter for Ao root shot went into RCA by accident- he saw, but before he could reposition, the contrast was injected- pt had to cough themselves out of aystole…