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Case Reports: Novel diagnostic procedure
Effect of coronary tortuosity on invasive physiology
  1. Annette Maznyczka1,
  2. Christopher Rajkumar2,
  3. Alex Hobson1 and
  4. Peter AJ Haworth1
  1. 1Department of Cardiology, Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
  2. 2Department of Cardiology, Imperial College London National Heart and Lung Institute, London, UK
  1. Correspondence to Dr Annette Maznyczka; amaznyczka{at}nhs.net

Abstract

We present a case of angina, where extreme coronary tortuosity affected invasive physiology interpretation. Extreme coronary tortuosity may lower fractional flow reserve and instantaneous wave-free ratio. Therefore, invasive physiology can be misleading in this setting, when used to evaluate stenosis significance, or when used post-percutaneous coronary (PCI) intervention for physiology guided stent optimisation.

  • Interventional cardiology
  • Ischaemic heart disease

https://doi.org/10.1136/bcr-2022-249095

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    Footnotes

    • Twitter @AMaznyczka

    • Contributors AM wrote the first draft of the manuscript. AM and PH conceived the idea for this manuscript. AM, PH and CR acquired, analysed and interpreted the invasive coronary physiology data. PH, CR and AH contributed to writing the manuscript and revising the work critically for intellectual content. All authors made the decision to submit.

    • Funding Christopher Rajkumar is a Clinical Research Training Fellow funded by the Medical Research Council [MR/S021108/1].

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.