Stress cardiomyopathy - Takotsubo and File:Coronary anatomy AHA.svg: Difference between pages
No edit summary |
No edit summary |
||
Line 1: | Line 1: | ||
1. PRXRCA (proximal right coronary artery). Main stem of RCA from the | |||
ostium to one half the distance to the acute margin of the heart. | |||
2. MIDRCA (middle RCA). Main stem of RCA from end of above segment | |||
to acute margin of the heart. | |||
3. DSTRCA (distal RCA). Main stem of RCA usually running along the | |||
posterior right atrioventricular groove, from the acute margin of the heart to | |||
the origin of the posterior descending artery (PDA). | |||
4. RPDA (right PDA). Artery of the posterior interventricular groove, | |||
which gives off septal perforators and is supplied by the distal right (90%). | |||
5. RPLS (right posterolateral segment). Continuation of the distal right | |||
beyond the origin of the posterior descending artery. This segment is situated | |||
in the posterior atrioventricular groove, in the region of the crux of the heart, | |||
and may have an inverted U-shaped configuration. It usually gives off the | |||
A-V node artery and a variable number of branches, which run parallel to the | |||
PDA, on the posterolateral surface (or inferior surface) of the left ventricle. | |||
6. RPL1 (first RPLS branch). First branch off the RPLS and often the only | |||
branch; synonym, left ventricular branch. | |||
7. RPL2 (second RPLS branch). Usually not present. | |||
8. RPL3 (third RPLS branch). Usually not present. | |||
9. Inf Septal (inferior septal). Posterior descending septal arteries are the | |||
septal perforator arteries originating from the PDA then extending into the | |||
inferior septunm. | |||
10. AC MARG (acute marginal vessels). A large branch or branches supplying | |||
the acute marginal wall of the right ventricle. The origin of the largest | |||
of these vessels may be variable, but usually coincides with the acute margin | |||
of the heart. These vessels are often an important source of collateral circulation. | |||
11. LMCA (left main coronary artery). Aortic ostium to bifurcation. | |||
12. PRXLAD (proximal left anterior descending). Extends from its origin | |||
off the left coronary artery to the first visible septal no matter how small this | |||
vessel is. In some cases there will be a major septal proceeded by one or more | |||
small septals. In this instance, the definition should still be rigidly adhered to | |||
and the first visible septal, no matter what size, should be used to indicate the | |||
end of the proximal segment of the LAD. | |||
13. MIDLAD (middle LAD). LAD immediately distal to the origin of the | |||
first major septal branch and extending to a point where the LAD forms an | |||
angle (Right anterior oblique [RAO] view), often, but not always, coinciding | |||
or close to the origin of the second diagonal branch. If said angle or branch | |||
is not identifiable, the segment ends one half the distance from the first major | |||
septal to the apex of the heart. | |||
14. DSTLAD (distal LAD). Terminal segment of the LAD running along | |||
the interventricular sulcus, beginning with the end of the previous segment, | |||
and usually extending beyond the apex. | |||
15. Ist DIAG (first diagonal; D-1). The largest, and usually the first, diagonal | |||
branch having its origin from the proximal segment of the LAD and | |||
supplying the anterior wall. Occasionally, a separate branch of the main left | |||
coronary artery. If there is no diagonal with its origin from the proximal LAD, | |||
then D-1 should be coded with a -5" under morphology of distal vessel to | |||
signify anatomically not present. | |||
16. 2nd DIAG (second diagonal; D-2). The second diagonal branch, which | |||
often has its origin at the angle of the anterior descending when visualized in | |||
the RAO projection. Origin is usually near junction of middle and distal thirds | |||
of LAD, but may come off higher, from MIDLAD. | |||
17. Ist Ant Septal (first anterior septal). This vessel is designated as the | |||
first large branch of the LAD to penetrate into the anterior interventricular | |||
septum. | |||
18. PRXCX (proximal circumflex). That portion of the circumflex artery | |||
from its origin off the main left coronary artery to and including the origin | |||
of the first obtuse marginal branch (No. 20). The distal circumflex (No. 19) | |||
may originate before the first marginal but the proximal circumflex continues | |||
until the origin of the first marginal. | |||
19. DSTCX (distal circumflex). Begins from the proximal portion of the | |||
circumflex as the circumflex runs along or close to the posterior left atrioventricular | |||
groove. In right dominant circulation, the distal circumflex may be | |||
very small or absent. | |||
Marginal circumflex branches that are very small or "twigs" are not to be | |||
counted as marginals or described. The first marginal branch (No. 20) may | |||
sometimes be a very large branch with the second marginal (No. 21) appearing | |||
as a division of the first marginal. All branches that come off the distal circumflex | |||
will be labeled marginals (Nos. 20, 21, and 22 below), and all branches | |||
that come off the left atrioventricular artery will be labeled left posterolateral | |||
branches (No. 24, 25, and 26 below). | |||
20. Ist OB MARC (first obtuse marginal). The first major branch of the | |||
circumflex artery supplying the lateral left ventricular wall, in the general | |||
area of the obtuse margin of the heart. | |||
21. 2nd OB MARC (second obtuse marginal). The second branch of the | |||
circumflex distributing to the lateral surface of the ventricle. Sometimes | |||
smaller in caliber than the first obtuse marginal. May be absent or may be a | |||
division of the first obtuse marginal branch. | |||
22. 3rd OB MARC (third obtuse marginal). The third branch of the circumflex | |||
supplying the posterolateral left ventricular wall (often absent). Runs | |||
parallel to the LPDA in the left predominant pattern. | |||
23. LAV (left atrial ventricular artery). The left atrial ventricular artery | |||
is present only in a left dominant or balanced circulation. This artery is a | |||
continuation of the distal circumflex and has been arbitrarily defined as the | |||
distal half of the remainder of the circumflex after the take-off of the first | |||
marginal. The proximal half of the circumflex after the take-off of the first | |||
marginal will be defined as the distal circumflex (No. 19). Note that this definition | |||
is appropriate only for left dominant or balanced circulation. | |||
Left posterolateral branches that are very small or "twigs" are not to be | |||
counted as branches or described. The first left posterolateral branch (No. 24) | |||
may sometimes be a very large branch with the second left posterolateral | |||
branch (No. 25) appearing as a division of the first branch. All branches that | |||
come off the distal circumflex will be labeled marginals (No. 20, 21, and 22), | |||
and all branches that come off the left atrioventricular artery will be labeled | |||
left posterolateral branches (Nos. 24, 25, and 26). | |||
24. 1st LPL (first left posterolateral branch). First branch off the LPL | |||
segment and often the only branch; synonym, left ventricular branch. | |||
25. 2nd LPL (second left posterolateral branch). Second branch off the | |||
LPL segment. | |||
26. 3rd LPL (third left posterolateral branch). Third branch off the LPL | |||
segment. Usually not present. | |||
27. LPDA (left PDA). Posterior descending when present as a branch of | |||
the circumflex in the predominant left coronary artery. |
Revision as of 21:02, 7 October 2009
1. PRXRCA (proximal right coronary artery). Main stem of RCA from the ostium to one half the distance to the acute margin of the heart. 2. MIDRCA (middle RCA). Main stem of RCA from end of above segment to acute margin of the heart. 3. DSTRCA (distal RCA). Main stem of RCA usually running along the posterior right atrioventricular groove, from the acute margin of the heart to the origin of the posterior descending artery (PDA). 4. RPDA (right PDA). Artery of the posterior interventricular groove, which gives off septal perforators and is supplied by the distal right (90%). 5. RPLS (right posterolateral segment). Continuation of the distal right beyond the origin of the posterior descending artery. This segment is situated in the posterior atrioventricular groove, in the region of the crux of the heart, and may have an inverted U-shaped configuration. It usually gives off the A-V node artery and a variable number of branches, which run parallel to the PDA, on the posterolateral surface (or inferior surface) of the left ventricle. 6. RPL1 (first RPLS branch). First branch off the RPLS and often the only branch; synonym, left ventricular branch. 7. RPL2 (second RPLS branch). Usually not present. 8. RPL3 (third RPLS branch). Usually not present. 9. Inf Septal (inferior septal). Posterior descending septal arteries are the septal perforator arteries originating from the PDA then extending into the inferior septunm. 10. AC MARG (acute marginal vessels). A large branch or branches supplying the acute marginal wall of the right ventricle. The origin of the largest of these vessels may be variable, but usually coincides with the acute margin of the heart. These vessels are often an important source of collateral circulation. 11. LMCA (left main coronary artery). Aortic ostium to bifurcation. 12. PRXLAD (proximal left anterior descending). Extends from its origin off the left coronary artery to the first visible septal no matter how small this vessel is. In some cases there will be a major septal proceeded by one or more small septals. In this instance, the definition should still be rigidly adhered to and the first visible septal, no matter what size, should be used to indicate the end of the proximal segment of the LAD. 13. MIDLAD (middle LAD). LAD immediately distal to the origin of the first major septal branch and extending to a point where the LAD forms an angle (Right anterior oblique [RAO] view), often, but not always, coinciding or close to the origin of the second diagonal branch. If said angle or branch is not identifiable, the segment ends one half the distance from the first major septal to the apex of the heart. 14. DSTLAD (distal LAD). Terminal segment of the LAD running along the interventricular sulcus, beginning with the end of the previous segment, and usually extending beyond the apex. 15. Ist DIAG (first diagonal; D-1). The largest, and usually the first, diagonal branch having its origin from the proximal segment of the LAD and supplying the anterior wall. Occasionally, a separate branch of the main left coronary artery. If there is no diagonal with its origin from the proximal LAD, then D-1 should be coded with a -5" under morphology of distal vessel to signify anatomically not present. 16. 2nd DIAG (second diagonal; D-2). The second diagonal branch, which often has its origin at the angle of the anterior descending when visualized in the RAO projection. Origin is usually near junction of middle and distal thirds of LAD, but may come off higher, from MIDLAD. 17. Ist Ant Septal (first anterior septal). This vessel is designated as the first large branch of the LAD to penetrate into the anterior interventricular septum. 18. PRXCX (proximal circumflex). That portion of the circumflex artery from its origin off the main left coronary artery to and including the origin of the first obtuse marginal branch (No. 20). The distal circumflex (No. 19) may originate before the first marginal but the proximal circumflex continues until the origin of the first marginal. 19. DSTCX (distal circumflex). Begins from the proximal portion of the circumflex as the circumflex runs along or close to the posterior left atrioventricular groove. In right dominant circulation, the distal circumflex may be very small or absent. Marginal circumflex branches that are very small or "twigs" are not to be counted as marginals or described. The first marginal branch (No. 20) may sometimes be a very large branch with the second marginal (No. 21) appearing as a division of the first marginal. All branches that come off the distal circumflex will be labeled marginals (Nos. 20, 21, and 22 below), and all branches that come off the left atrioventricular artery will be labeled left posterolateral branches (No. 24, 25, and 26 below). 20. Ist OB MARC (first obtuse marginal). The first major branch of the circumflex artery supplying the lateral left ventricular wall, in the general area of the obtuse margin of the heart. 21. 2nd OB MARC (second obtuse marginal). The second branch of the circumflex distributing to the lateral surface of the ventricle. Sometimes smaller in caliber than the first obtuse marginal. May be absent or may be a division of the first obtuse marginal branch. 22. 3rd OB MARC (third obtuse marginal). The third branch of the circumflex supplying the posterolateral left ventricular wall (often absent). Runs parallel to the LPDA in the left predominant pattern. 23. LAV (left atrial ventricular artery). The left atrial ventricular artery is present only in a left dominant or balanced circulation. This artery is a continuation of the distal circumflex and has been arbitrarily defined as the distal half of the remainder of the circumflex after the take-off of the first marginal. The proximal half of the circumflex after the take-off of the first marginal will be defined as the distal circumflex (No. 19). Note that this definition is appropriate only for left dominant or balanced circulation. Left posterolateral branches that are very small or "twigs" are not to be counted as branches or described. The first left posterolateral branch (No. 24) may sometimes be a very large branch with the second left posterolateral branch (No. 25) appearing as a division of the first branch. All branches that come off the distal circumflex will be labeled marginals (No. 20, 21, and 22), and all branches that come off the left atrioventricular artery will be labeled left posterolateral branches (Nos. 24, 25, and 26). 24. 1st LPL (first left posterolateral branch). First branch off the LPL segment and often the only branch; synonym, left ventricular branch. 25. 2nd LPL (second left posterolateral branch). Second branch off the LPL segment. 26. 3rd LPL (third left posterolateral branch). Third branch off the LPL segment. Usually not present. 27. LPDA (left PDA). Posterior descending when present as a branch of the circumflex in the predominant left coronary artery.