Hakkı KAYA, Orhan DOĞDU, Utku KÜTÜK, Ali ZORLU, Hasan YÜCEL

Anomalous single coronary artery accompanied by accessory mammary tissue presenting with typical angina pectoris

Tek koroner arter, aort kökünden tek koroner ostiyum aracılığıyla çıkan ve ikinci bir ostiyumungözlenmediği izole koroner arter olarak tanımlanır. Tek koroner arter bütün kalbin kan akımınınsağlanmasından sorumludur. Bu olguda, tipik göğüs ağrısı nedeniyle polikliniğe başvuran, fizikmuayenesinde aksesuar meme dokusu olan ve ek fizik muayene bulgusu olmayan bir hastasunuldu. Hiperlipidemi ve hipertansiyon risk faktörleri olan hastaya koroner anjiyografi planlandı.Yapılan koroner anjiyografide tek koroner arter saptanan 72 yaşında erkek hasta sunuldu. Koroneranjiyografide tüm koroner sistemin sağ sinüs valsalvadan çıkan tek gövdeden kalp bölgesineyayılım gösterdiği saptandı. Çokkesitli bilgisayarlı tomografide, sol ön inen, sirkumfleks ve sağkoroner arterlerin sol ana gövde olmaksızın tek ostiyum aracılığı ile sağ sinüs Valsalva düzeyindetek gövdeden köken aldıkları izlendi. Ek konjenital anomali izlenmedi. Nonkritik darlıkları olanhasta medikal tedavi ile taburcu edildi. Koroner arter ve meme dokusunun embriyonal dönemdegelişmesinde, nöral krista hücreleri, matriks metalloproteinazlar, epidermal büyüme faktörreseptörleri, vasküler endotelyal büyüme faktörü ve reseptörleri etkilidir. Nöral krista hücreleriningöç yollarının etkilenmesi ya da ekspresyon ürünlerinin sentezlenmesindeki bir aksaklık bu tür biranomali oluşmasına yol açmış olabilir.

Tip ik angina p ektorisle başvuran tek koroner arter anomalisi ve aksesuar meme dokusu birlikteliği

Single coronary artery is described as an isolated coronary artery originating from the aortic rootthrough a single ostium in the absence of another ostium. The single coronary artery is the onlysource for blood supply to the whole heart. In this case we present a patient admitted to theoutpatient clinic with typical chest pain, whose physical examination indicated accessorymammary tissue without any additional physical examination findings. The patient hadhyperlipidemia and hypertension risk factors, and a coronary angiography was planned. Thecoronary angiography performed on the 72 year old male patient revealed a single coronary artery.According to the angiography, it is reported that the whole coronary system is distributed to theheart from a single trunk originating from the right sinus of valsalva. The multislice computerizedtomography showed that the left anterior descending, circumflex and right coronary arteriesoriginated from single trunk at the level of right sinus of valsalva through a single ostium withoutthe left main trunk. There was no additional congenital anomaly. The patient, who had noncriticalstrictures, was discharged with medical treatment. Neural crest cells, matrix metalloproteinase,epidermal growth factor receptors, vascular endothelial growth factor and receptors are effective inthe development of coronary arteries and mammary tissues in the embryonic phase. Any impact onthe migration routes of the neural crest cells or distortion of the synthesis of expression productsmay have caused this kind of an anomaly.

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