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. 2013 Feb;43(2):123-6.
doi: 10.4070/kcj.2013.43.2.123. Epub 2013 Feb 28.

Myocardial ischemia caused by paroxysmal supraventricular tachycardia in a patient with anomalous origin of right coronary artery arising from left sinus of valsalva

Affiliations

Myocardial ischemia caused by paroxysmal supraventricular tachycardia in a patient with anomalous origin of right coronary artery arising from left sinus of valsalva

Sang Hee Song et al. Korean Circ J. 2013 Feb.

Abstract

Anomalous origin of a coronary artery is rare and does not generally lead to myocardial infarction and paroxysmal supraventricular tachycardia (PSVT). We report an uncommon case of anomalous origin of the right coronary artery (RCA) originating from the left sinus of Valsalva with PSVT and myocardial ischemia. A 58-year-old man presented with PSVT. After arrhythmia subsided, electrocardiogram showed ST and T wave abnormalities, and transient cardiac enzymes were found to be elevated. Coronary CT angiography confirmed that there was anomalous origin of the RCA originating from the left sinus of Valsalva and no intracoronary stenotic lesion. He was managed with conservative treatment, having no symptoms on clinical follow-up for 4 years.

Keywords: Coronary vessel anomalies; Multidetector computed tomography; Myocardial ischemia; Tachycardia, paroxysmal.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Variable changes of ECG. A: ECG show paroxysmal supraventricular tachycardia with pulse rate 190. B: ECG show ST elevation in leads V 1-3 and T inversion in leads II, III, aVF and V 4-6. C: electrocardiogram show T wave inversion in leads II, III, aVF and V 3-6. ECG: electrocardiogram.
Fig. 2
Fig. 2
Anomalous orgin of the right coronary artery with CT coronary angiography. A: multiplanar reformatted image from a multi-detector CT coronary angiogram confirms that the right coronary artery was arising from the left sinus Valsalva with acute angle of the ostium (arrow). B: axial reconstruction anomaly coronary artery takes a course between the right ventricular outflow tract and the aorta (arrow) on axial image.
Fig. 3
Fig. 3
3D volume rendered multi-detector CT image of the coronary arteries show that there is no stenosis of any coronary artery.

References

    1. Kimbiris D, Iskandrian AS, Segal BL, Bemis CE. Anomalous aortic origin of coronary arteries. Circulation. 1978;58:606–615. - PubMed
    1. Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn. 1990;21:28–40. - PubMed
    1. Angelini P, Velasco JA, Flamm S. Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation. 2002;105:2449–2454. - PubMed
    1. Kim JS, Lee JM, Yoon HJ, et al. A case of coronary vessel anomaly of the left circumflex artery originating from the right coronary artery with variant angina. Korean Circ J. 2004;34:711–714.
    1. Vincelj J, Todorović N, Marusić P, Puksić S. Anomalous origin of the left coronary artery from the right sinus of Valsalva in a 62-year-old woman with unstable angina pectoris: a case report. Int J Cardiol. 2010;142:e35–e37. - PubMed

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