{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:39Z","timestamp":1753876239149,"version":"3.41.2"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,4,16]],"date-time":"2022-04-16T00:00:00Z","timestamp":1650067200000},"content-version":"vor","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004756","name":"Emil Aaltonen Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004756","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Coronary artery anomalies (CAAs) are congenital disorders associated with variable manifestations and pathophysiological mechanisms. Anomalies can be asymptomatic or cause chest pain, myocardial infarction, or even sudden cardiac death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We describe a 34-year-old man with a history of a single episode of chest pain. An ectopic origin on the part of the left circumflex (LCX) coronary artery from the proximal right coronary artery (RCA) was evident upon coronary computed tomography angiography. A positron emission tomography perfusion study revealed a stress-induced perfusion defect in the anomalous LCX territory (infero-posterior wall). The patient experienced dyspnoea and ST-segment depression in electrocardiography, suggestive of myocardial ischaemia during the maximal bicycle ergometer stress test. No mechanical compression or stenosis was seen upon invasive coronary angiography. The left ventricular perfusion normalized after the initiation of beta-blocker medication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Patients with CAAs especially benefit from a multimodality assessment of the vascular territories. In our case, the myocardial perfusion of the infero-posterior wall normalized after treatment with beta-blockers. This may be due to increased coronary vasodilation capacity and myocardial flow reserve, as well as reduced oxygen consumption. Beta-blockers may represent a viable option in low-symptomatic CAA patients with perfusion defect and no ostial stenosis or compression.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac171","type":"journal-article","created":{"date-parts":[[2022,4,16]],"date-time":"2022-04-16T11:21:00Z","timestamp":1650108060000},"source":"Crossref","is-referenced-by-count":0,"title":["Reversible myocardial ischaemia caused by ectopic left circumflex coronary artery: a case report"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8130-3219","authenticated-orcid":false,"given":"Saara","family":"Sillanm\u00e4ki","sequence":"first","affiliation":[{"name":"Diagnostic Imaging Center, Kuopio University Hospital, PO Box 100, 70029 KYS Kuopio, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2497-653X","authenticated-orcid":false,"given":"Maria","family":"Istomina","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Center, Kuopio University Hospital, PO Box 100, 70029 KYS Kuopio, Finland"},{"name":"HeartCenter, Kuopio University Hospital, Kuopio, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7109-1876","authenticated-orcid":false,"given":"Annastiina","family":"Husso","sequence":"additional","affiliation":[{"name":"HeartCenter, Kuopio University Hospital, Kuopio, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1318-8287","authenticated-orcid":false,"given":"Marja","family":"Hedman","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Center, Kuopio University Hospital, PO Box 100, 70029 KYS Kuopio, Finland"},{"name":"HeartCenter, Kuopio University Hospital, Kuopio, Finland"},{"name":"Institute of Medicine, University of Eastern Finland, Kuopio, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,4,16]]},"reference":[{"key":"2022042814500047800_ytac171-B1","first-page":"121","article-title":"The primary anomalies of coronary artery origin and course: a coronary angiographic analysis of 16,573 patients","volume":"18","author":"Yuksel","year":"2013","journal-title":"Exp Clin Cardiol"},{"key":"2022042814500047800_ytac171-B2","first-page":"273","article-title":"Myocardial ischemia caused by a coronary anomaly: left circumflex coronary artery arising from right sinus of valsalva","volume":"31","author":"Aydin","year":"2004","journal-title":"Tex Heart Inst J"},{"key":"2022042814500047800_ytac171-B3","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1186\/1757-1626-1-336","article-title":"Anomalous origin of the left circumflex artery from the right coronary artery: a case report","volume":"1","author":"Plastiras","year":"2008","journal-title":"Cases J"},{"key":"2022042814500047800_ytac171-B4","first-page":"299","article-title":"Surgical treatment of coronary artery anomalies: report of a 37 1\/2-year experience at the Texas Heart Institute","volume":"29","author":"Reul","year":"2002","journal-title":"Texas Heart Inst J"},{"key":"2022042814500047800_ytac171-B5","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1016\/j.athoracsur.2003.08.084","article-title":"Surgical treatment of right coronary arteries with anomalous origin and slit ostium","volume":"77","author":"Garc\u00eda-Rinaldi","year":"2004","journal-title":"Ann Thorac Surg"},{"key":"2022042814500047800_ytac171-B6","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1016\/j.jacc.2014.05.069","article-title":"Quantitative assessment of myocardial perfusion in the detection of significant coronary artery disease: cutoff values and diagnostic accuracy of quantitative [(15)O]H2O PET imaging","volume":"64","author":"Danad","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2022042814500047800_ytac171-B7","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1161\/hc0402.102975","article-title":"American heart association writing group on myocardial segmentation and registration for cardiac imaging. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association","volume":"105","author":"Cerqueira","year":"2002","journal-title":"Circulation"},{"key":"2022042814500047800_ytac171-B8","doi-asserted-by":"crossref","first-page":"198","DOI":"10.2967\/jnumed.109.067488","article-title":"Definition of vascular territories on myocardial perfusion images by integration with true coronary anatomy: a hybrid PET\/CT analysis","volume":"51","author":"Javadi","year":"2010","journal-title":"J Nucl Med"},{"key":"2022042814500047800_ytac171-B9","first-page":"1626","article-title":"Beta-adrenergic blockade and myocardial perfusion in coronary artery disease: differential effects in stenotic versus remote myocardial segments","volume":"45","author":"Koepfli","year":"2004","journal-title":"J Nucl Med"},{"key":"2022042814500047800_ytac171-B10","first-page":"442","article-title":"Effect of beta 1 adrenergic receptor blockade on myocardial blood flow and vasodilatory capacity","volume":"38","author":"Bottcher","year":"1997","journal-title":"J Nucl Med"},{"key":"2022042814500047800_ytac171-B11","doi-asserted-by":"crossref","first-page":"2009","DOI":"10.1093\/eurheartj\/ehx046","article-title":"Outcome in middle-aged individuals with anomalous origin of the coronary artery from the opposite sinus: a matched cohort study","volume":"38","author":"Grani","year":"2017","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytac171\/43386011\/ytac171.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/4\/ytac171\/43481515\/ytac171.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/4\/ytac171\/43481515\/ytac171.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T16:29:45Z","timestamp":1651163385000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytac171\/6569211"}},"subtitle":[],"editor":[{"given":"Frances","family":"Musella","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Erica","family":"Tirr","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Jonathan Adam","family":"Batty","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Oliver Ian","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Ameenathul Mazaya","family":"Fawzy","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,4,1]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4,13]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytac171","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2022,4,1]]},"published":{"date-parts":[[2022,4,1]]},"article-number":"ytac171"}}