Anomalous Origin of the Right Coronary Artery: An Uncommon Presentation

Shaban, Μ. A. E.; Budhathoki, Pravash; Bhatt, Tanushree; Lee, Somin; Neme, Ana P Urena; Guerra, Miguel A Rodriguez; Zaw, May

doi:10.7759/cureus.25494

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…The origin and course of abnormal coronary arteries can be visualized with a three-dimensional anatomical display using axial reconstructions from multidetector CTA. Some authors advocate using CT as the first-line investigation when CAA is suspected, as the exact position and course of the anomalous artery can be viewed about the aortic root and pulmonary artery (Shaban et al, 2022).…”

Section: Resultsmentioning

confidence: 99%

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Coronary Artery Disease in Patient with An Anomalous Origin of Right Coronary Artery

D. Nugraheni,

Meuthia

2024

ihj

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Coronary artery disease (CAD) remains a leading cause of mortality and morbidity in developed countries. CAD is a pathological process characterized by the accumulation of atherosclerotic plaques in the epicardial arteries, both obstructive and non-obstructive. This study aims to investigate rare cases of anomalous right coronary artery arising from the left main coronary artery and its clinical implications for coronary artery disease (CAD). The research methodology involved clinical examinations, echocardiography, diagnostic coronary angiography, and computed tomography angiography (CCTA) to obtain a comprehensive understanding of this case. The research findings indicate severe stenosis in the proximal-mid left main coronary artery (LAD) and an anomalous origin of the right coronary artery (RCA) leading to lower-level stenosis. Percutaneous coronary intervention (PCI) on the proximal-mid LAD lesion resulted in significant improvement in the patient's condition. The implications of this research underscore the importance of a deep understanding of coronary artery anatomical variations for accurate diagnosis and appropriate management of CAD patients, especially in rare cases like this.

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Section: Resultsmentioning

confidence: 99%

“…Anomalous origin of the right coronary artery is uncommon, with a reported incidence of 0,26% (Shaban et al, 2022). An anomalous origin of the right coronary artery is usually asymptomatic (Villa et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Coronary Artery Disease in Patient with An Anomalous Origin of Right Coronary Artery

D. Nugraheni,

Meuthia

2024

ihj

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“…AAOCA, including ARCA-L, is a potentially lethal condition associated with malignant arrhythmia, stenocardia, myocardial infarction, and SCD in young adults, highlighting the need to diagnose AAOCA and ARCA-L [ 5 , 14 ]. D’Ascenzi et al [ 15 ] reported that AAOCA accounts for 7.2% of the SCDs in athletes and 1.9% of the SCDs in non-athletes.…”

Section: Discussionmentioning

confidence: 99%

Anomalous right coronary artery originating from the aorta: a series of nine pediatric cases

Na,

Chen,

Zhen

et al. 2023

BMC Pediatr

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Background To investigate the clinical manifestations, prognosis, and possibly related genes of anomalous right coronary artery originating from the aorta (ARCA-L) in children. Methods This case series study included pediatric patients diagnosed with ARCA-L at the Department of Cardiology in Beijing Children’s Hospital affiliated to Capital Medical University, between January 2017 and December 2019. Results Nine pediatric patients (aged 3 months to 12 years, 4 boys) were included. Two cases presented with cardiac insufficiency as their primary manifestation, while the remaining seven had post-infection or post-exercise symptoms such as chest pain, chest tightness, long exhalation, lack of strength, and dizziness. Six patients displayed varying degrees of ST-T changes on the electrocardiograph, while two patients had a reduced left ventricular ejection fraction (LVEF) of 20-32% according to echocardiography. Multislice computed tomographic angiography confirmed the presence of ARCA-L in all patients. One patient underwent the unroofing technique. The remaining eight received conservative treatment. After a follow-up of 2–64 months, eight children had a good prognosis and survived. One child experienced sudden death due to aggravated heart failure. Whole exome sequencing revealed that one child tested negative, one had mutations in the RYR2 and LDB3 genes, and the remaining four patients had a mutation in the GDF1, LRP6, MEF2A, and KALRN genes, respectively. Conclusions ARCA-L in children might have a wide variation in clinical manifestations and a risk of sudden death. The occurrence of the disease might be associated with genetic defects.

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“…Most patients do not exhibit symptoms or only experience them after strenuous physical activity. Nonetheless, patients can present with angina, myocardial infarction, syncope, arrhythmia, or sudden cardiac arrest [ 16 , 17 ]. The onset of symptoms is unpredictable, and the first symptom may be SCD.…”

Section: Discussionmentioning

confidence: 99%

Anomalous Coronary Arteries: A Cause for Malignant Arrhythmias

AlQubbany,

Alqurashi,

Zagzoog

et al. 2023

Cureus

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Anomalous aortic origin of a coronary artery (AAOCA) is a congenital condition that can lead to sudden cardiac death (SCD), particularly among young individuals. The cause of SCD is thought to be ischemia, primarily related to the course of the anomalous coronary artery. Surgical intervention, such as unroofing or coronary revascularization, is the preferred management modality for patients with evidence of ischemia or concomitant fixed obstruction. Herein, we presented a case of a 24-year-old male admitted to the emergency department with a history of palpitations, dyspnea, diaphoresis, and syncope. The patient had no prior medical diseases and was eventually diagnosed with an anomalous right coronary artery (ARCA) originating from the left coronary sinus. The patient underwent surgical unroofing of the ARCA to prevent further episodes of ischemia and ventricular arrhythmias. The case highlights that coronary artery anomalies can be life-threatening and lead to SCD, especially in young individuals with no risk factors. Investigating coronary anomalies in medically free patients presenting with cardiac symptoms and arrhythmias is crucial.

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Anomalous Origin of the Right Coronary Artery: An Uncommon Presentation

Cited by 3 publications

References 18 publications

Coronary Artery Disease in Patient with An Anomalous Origin of Right Coronary Artery

Coronary Artery Disease in Patient with An Anomalous Origin of Right Coronary Artery

Anomalous right coronary artery originating from the aorta: a series of nine pediatric cases

Anomalous Coronary Arteries: A Cause for Malignant Arrhythmias

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