Left Main Coronary Artery Arising from the Right Coronary Sinus Presenting as Acute Coronary Syndrome

Abstract

Coronary artery anomalies are extremely rare with a prevalence of 2.33% and they are extremely difficult to diagnose with the help of conventional tests. Once diagnosed, the associated life-threatening risks and complications that arise during surgical management are the dangers related to such anomalies. We present a case of a 45–year-old female, with chief complaints of chest pain radiating to back and left shoulder associated with palpitations for 7 days, a known case of systemic hypertension and diabetes mellitus type 2 for 7 years on regular medications. A series of investigations were conducted that included an electrocardiogram showing ischemic changes, a two-dimensional echocardiography that revealed globally dysfunctional left ventricle and an ejection fraction of 45%, and finally, a diagnostic coronary angiography leading to the diagnosis of the an abnormal origin of the left main coronary artery through the right coronary sinus associated with 80% stenotic lesion in the “left anterior descending artery” and 90% stenotic lesion in the “left circumflex artery”. The report concludes that anomalies arising from coronary arteries are extremely infrequent and difficult to diagnose. In addition, they can present with life-threatening complications during surgical management.

Marfanoid to Mortality: A Case Report on Sudden Cardiac Death Due to Aortic Dissection in a Young Male With Marfanoid Habitus

“…The patient's rapid progression to shock despite medical intervention highlights the aggressive nature of aortic dissection in the context of MFS. The compromised hemodynamics and the intricate vascular pathology in this case underscore the challenges faced by clinicians in stabilizing patients with such advanced cardiovascular complications [9]. The wide pulse pressure observed in the blood pressure readings further reflects the severity of the hemodynamic compromise and emphasizes the urgency for intervention [10].…”

Unraveling the Trio of Interrupted Descending Aorta, Aortic Stenosis, and Bicuspid Aortic Valve: A Complex Cardiovascular Conundrum

“…CTA is the gold standard for evaluating aortic interruption [9]. Early diagnosis of congenital heart defects including evaluation of the aorta and coronaries is important for better management strategies [10,11]. The management of an IAA typically involves surgical interventions to restore the continuity of the aortic arch as well as addressing any associated cardiac abnormalities.…”