Dr.Mario(Z)
6.4K posts
@DrMarioZ1
TJ/AGS/CDMX🇲🇽, Cardiólogo ❤️, Cardiólogo Intervencionista 🫀, Médico General👨🏾⚕️ y especialista en Cannabis Medicinal. Gamer.
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Cómo se siente escribir tu correo y contraseña con el mando de la tele
🔴 Malignant Course of Coronary Artery A malignant course of a coronary artery refers to an anomalous path that puts the artery at risk of compression, especially during exertion—potentially leading to ischemia, syncope, or sudden cardiac death. 🔴 Most Important Type (Classic “Malignant”) 》Interarterial course ● The coronary artery passes between the aorta and pulmonary artery ● Typically seen in: ○ Anomalous RCA from left sinus ○ Anomalous LCA from right sinus (more dangerous). 👉 Why dangerous? The artery gets compressed during exercise due to expansion of great vessels Often associated with: ▪︎ Slit-like ostium. ▪︎ Acute takeoff angle. ▪︎ Intramural aortic segment. ⚠️ Other High-Risk Features Even within anomalous coronaries, risk increases with: ▪︎ Intramural course (within aortic wall). ▪︎ Slit-like orifice. ▪︎ Acute angle takeoff. ▪︎ Proximal narrowing. 🟡 Benign vs Malignant Courses 🟢 Benign: Retroaortic Prepulmonic Septal (subpulmonic/intramyocardial). 🔴 Malignant: Interarterial (between aorta & PA) 💡 Clinical Presentation ● Often asymptomatic ● Exertional: ▪︎ Chest pain ▪︎ Syncope ▪︎ Arrhythmias ● Sudden cardiac death (especially young athletes) 🧪 Diagnosis ▪︎ Coronary CT angiography → best to define course ▪︎ Conventional angiography may miss the 3D relationship. 🛠️ Management ● High-risk anatomy or symptoms → surgery ○ Unroofing procedure ○ Reimplantation ● Asymptomatic low-risk → observation ± restriction. 🧠 Exam Pearls ● Not all anomalies are dangerous → course matters more than origin. ● LCA from right sinus + interarterial course = highest risk. ● Think of this in young patient with exertional syncope or SCD. #viralchallenge #lifestyle #cardiology #medicine
Documentation is your defense system against losing your medical licence. ”Despite counselling on the need of admission and urgent care. patient insists there's a tea at home that would cure his heart failure”
