Anomalous Left Coronary Artery Arising From Right Coronary Sinus in the Setting of Anterior STEMI

Rajani, Prina; ElMaghawry, Mohamed; Mittal, Tarun; Mattar, Wala

doi:10.1016/j.jaccas.2021.04.003

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…The presence of this congenital abnormality increases the technical challenge and risks of procedural complications. 2 , 3 To date, there have been rare reports of AAOCA encountered during STEMI, 3 , 12 and ours is the first reported case of an occluded anomalous LMCA arising from the right coronary sinus. Given the large myocardial territory at risk, prompt revascularization was critical to achieving a good outcome in this case.…”

Section: Discussionmentioning

confidence: 76%

A case report of successful primary percutaneous coronary intervention to an occluded anomalous left main coronary artery arising from the right coronary sinus

Wong,

Pogatchnik,

Clark

et al. 2024

European Heart Journal - Case Reports

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Background Anomalous aortic origin of a coronary artery (AAOCA) from the opposite sinus is a rare congenital abnormality that may be encountered during primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). Case summary A 65 year old man presented with chest pain and signs of heart failure. Electrocardiogram demonstrated atrial fibrillation with ST elevation in the high lateral leads, and he was taken emergently to the cardiac catheterization laboratory for primary PCI. Coronary angiography identified the culprit to be an occluded anomalous left main coronary artery (LMCA) arising from the right coronary cusp, and primary PCI was successfully performed in the LMCA and LAD. Computed tomography angiography (CTA) confirmed a benign retroaortic course of the anomalous LMCA with no additional high risk features, as well as a new left atrial appendage thrombus. He subsequently developed deep venous thrombosis, acute pulmonary embolism, and acute kidney injury secondary to renal artery embolism with associated infarction. Workup for patent foramen ovale and thrombophilia were negative, and he was discharged in a stable condition. At 2-month follow-up, he was asymptomatic with no evidence of myocardial ischemia on stress cardiac magnetic resonance imaging. Discussion We present the first reported case of an occluded anomalous LMCA arising from the right coronary sinus in a patient presenting with STEMI. Rapid recognition of this congenital anomaly and selection of an appropriate guide catheter were keys to achieving timely reperfusion and a good outcome in this case.

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Section: Discussionmentioning

confidence: 76%

A case report of successful primary percutaneous coronary intervention to an occluded anomalous left main coronary artery arising from the right coronary sinus

Wong,

Pogatchnik,

Clark

et al. 2024

European Heart Journal - Case Reports

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Aberrant Right Coronary Artery from the Left Coronary Sinus Presenting with Inferior Wall Myocardial Infarction

Toshniwal,

Kumar

et al. 2024

International Journal of Applied &Amp; Basic Medical Research

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Coronaries arise normally from the aortic sinus which consists of one anterior and two posterior cusps of which the right coronary artery (RCA) arises from the anterior cusp and the left coronary artery arises from the left posterior cusp. Abnormal origin of coronary arteries is very rare and counts for about 2.33% of prevalence and below 1% incidence and are comparatively very difficult to diagnose through routine investigations. Till date, only one case has been reported in the literature where the culprit vessel was the victim as seen in our case. We report a case of a 68-year-old male, who underwent coronary angiography for his anginal chest pain, was diagnosed with coronary artery disease with an “abnormally arising RCA” from the left coronary cusp with a proximal stenotic lesion in the anomalously arising RCA, which was confirmed on multidetector computed tomography three-dimensional reconstruction volume-rendered imaging.

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Anomalous Left Coronary Artery Arising From Right Coronary Sinus in the Setting of Anterior STEMI

Cited by 2 publications

References 6 publications

A case report of successful primary percutaneous coronary intervention to an occluded anomalous left main coronary artery arising from the right coronary sinus

A case report of successful primary percutaneous coronary intervention to an occluded anomalous left main coronary artery arising from the right coronary sinus

Aberrant Right Coronary Artery from the Left Coronary Sinus Presenting with Inferior Wall Myocardial Infarction

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