Abstract
Atavism is the rare reappearance, in a modern organism, of a trait from a distant evolutionary ancestor. We describe an apparent case of atavism involving a 59-year-old man with chest pain whose coronary circulation and myocardial architecture resembled those of the reptilian heart. The chest pain was attributed to a coronary steal phenomenon. The patient was discharged from the hospital on a heightened regimen of β-blockers, and his symptoms improved significantly. To our knowledge, this is only the 2nd reported clinical case of a human coronary circulation similar to that of reptiles.
Keywords:
Anatomy, comparative; angina pectoris/etiology; coronary circulation/physiology; coronary steal; coronary vessels/anatomy & histology; embryology, cardiac; evolution; fistula/diagnosis; heart defects, congenital/pathology/radiography; heart/anatomy & histology; laser therapy; microcirculation; morphology, cardiac; reptiles; snakes; veins/anatomy & histology.
MeSH terms
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Abnormalities, Multiple*
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Adrenergic beta-Antagonists / therapeutic use
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Angina Pectoris / drug therapy
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Angina Pectoris / etiology*
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Angina Pectoris / physiopathology
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Animals
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Coronary Angiography
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Coronary Circulation
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Coronary Vessel Anomalies / complications
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Coronary Vessel Anomalies / diagnosis*
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Coronary Vessel Anomalies / drug therapy
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Coronary Vessel Anomalies / physiopathology
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Humans
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Isolated Noncompaction of the Ventricular Myocardium / complications
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Isolated Noncompaction of the Ventricular Myocardium / diagnosis*
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Isolated Noncompaction of the Ventricular Myocardium / drug therapy
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Isolated Noncompaction of the Ventricular Myocardium / physiopathology
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Male
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Middle Aged
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Myocardial Ischemia / drug therapy
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Myocardial Ischemia / etiology*
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Myocardial Ischemia / physiopathology
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Snakes / anatomy & histology*
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Treatment Outcome
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Vascular Fistula / congenital
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Vascular Fistula / diagnosis*
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Vascular Fistula / drug therapy
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Vascular Fistula / physiopathology
Substances
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Adrenergic beta-Antagonists