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Case Reports
. 2017 Mar;9(3):221-224.
doi: 10.14740/jocmr2848w. Epub 2017 Jan 25.

Atypical Double Right Coronary Artery Presenting With Acute Coronary Syndrome, Cardiogenic Shock and Complete Heart Block

Santosh Kumar Sinha  1 , Shravan Singh  1 , Vikash Chaturvedi  1 , Puneet Agrawal  1 , Mahmadula Razi  1 , Anupam Mahrotra  1 , Vikas Mishra  1 , Mukesh Kumar  1 , Nasar Abdali  1 , Dibbendhu Khanra  1 , Ramesh Thakur  1 , Chandra Mohan Varma  1 , Umeshwar Pandey  1
Affiliations
Case Reports

Atypical Double Right Coronary Artery Presenting With Acute Coronary Syndrome, Cardiogenic Shock and Complete Heart Block

Santosh Kumar Sinha et al. J Clin Med Res. 2017 Mar.

Abstract

Double right coronary artery (RCA) is an extremely rare coronary artery anomaly. We here report an atherosclerotic double RCA which appeared after primary percutaneous intervention performed to treat a 34-year-old male presenting with acute inferior myocardial infarction, cardiogenic shock and complete heart block. This is an unusual case as double RCA had been hidden by total atherosclerotic occlusion of the proximal part of the RCA and complete restoration of patency led complete heart block back to normal sinus rhythm.

Keywords: Complete heart block; Cardiogenic shock; Coronary artery anomaly; Double right coronary artery; Myocardial infarction.

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Figures

Figure 1
Figure 1
(a) Electrocardiogram showing complete heart block; (b) 2:1 atrioventricular block; (c) Wenckebach phenomenon; (d) Normal sinus rhythm.
Figure 2
Figure 2
Basal angiogram showing occlusion of proximal RCA.
Figure 3
Figure 3
Fielder FC guide wire over finecross microcatheter beyond the lesion.
Figure 4
Figure 4
(a) BMW guide wire parked distally after exchange with Feider wire; (b) lesion being predilated with 2 × 10 Minitrak balloon; (c) stent being deployed across the lesion; (d) stent being post-dilated with non-compliant balloon.
Figure 5
Figure 5
Atypical right coronary artery after stent deployment.
See this image and copyright information in PMC

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