Stress cardiomyopathy - Takotsubo and File:Coronary anatomy AHA.svg: Difference between pages
(Difference between pages)
Jump to navigation
Jump to search
no edit summary
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. |