The Frequency and Manner of Presentation of Anomalous Coronary Artery Origin in an Unselected Australian Population Undergoing Coronary Angiography

Abstract

coronary angiography between 01/07/2007 and 31/03/2009 at The Prince Charles Hospital. Using their medical records we identified cardiac risk factors, demographic data, cardiac arrest treatment times, ECG and angiographic findings, revascularization rates and in-hospital outcomes. Results: 45 patients underwent coronary angiography with a diagnosis of OOHCA. This was 0.74% of all cardiac catheterizations (6072) performed during the period. Cardiac risk factors in this group were: hypertension 48.9%, hyperlipidaemia47.4%,diabetes 11.1%,historyof smoking 77.8%,known ischaemicheartdisease31.1%andrenal failure 26.7%. 29.5% had chest pain prior to the event. 57.7% had initial treatment at a peripheral hospital. 88.9% had documented VT/VF by the ambulance. 68.3% had LV dysfunction on presentation. 60% had specific ECG changes – most commonly in the anterior leads (48.1%). In this group, those whose initial presentation was to our hospital, 94.7% had immediate coronary angiography. 75.5% of patients hadAMIas cause for cardiac arrest and themajority of patients were found to have multi-vessel disease. In-hospital survival was 80.0% with neurological deficit in 22.2% of survivors. Conclusions:AMIwas the commonest causeofOOHCA in this group despite an absence of specific ECG changes in 40%. Excellent survival to discharge was seen in this cohort receiving early angiography and intervention. doi:10.1016/j.hlc.2010.06.748