SINOATRIAL NODE ARTERY COMMUNICATED WITH CUT-OFF LEFT ANTERIOR DESCENDING ARTERY

Year 2012, Volume: 1 Issue: 2, 96 - 96, 30.08.2012

Turgay Işık , Erkan Ayhan

Abstract

The artery that supplies the sinoatrial node (SAN) artery was a branch of either the
right or left coronary artery. Most frequently (in 63% of case), the SAN node artery
was the first anterior atrial branch of right coronary artery. A 79 year old male was
presented to our cardiology department with gradually progressive typical chest pain
for the preceding one year. He had no history coronary artery disease. On physical
examination, his arterial blood pressure was seen 135/75 mmHg and the
electrocardiogram revealed sinus rhythm and heart rate was 75 bpm/regular. Cardiac
auscultation showed 2/6 grade systolo-diastolic murmur and the rest of physical
examination including respiratory sounds was unremarkable.
Transthoracic echocardiography showed hypokinetic walls in the left ventricular apex
and interventricular septum in mid and apical sections, mild mitral and aortic
regurgitation with a calculated ejection fraction of 38% by using modified Simpson’s
rule. Coronary angiography showed right coronary artery was high grade stenosis
from the after SAN artery and circumflex artery had critical lesion from the proximal
segment. The left coronary artery was totally occluded from the midportion and was
supplied retrograde fashion by the SAN artery (Figure 1A and 1B). The patient was
referred to the cardiovascular surgery department for coronary artery bypass
operation. However, he refused the surgical operation or percutaneous coronary
intervention. He was discharged on medical treatment

Keywords

Sinoatrial node, Arterior descending artery

References

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