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Case Reports
. 2021 Jun 2;3(9):1182-1186.
doi: 10.1016/j.jaccas.2021.04.003. eCollection 2021 Aug 4.

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

Prina Rajani  1 , Mohamed ElMorsy ElMaghawry  1 , Tarun Mittal  2 , Wala Mattar  1
Affiliations
Case Reports

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

Prina Rajani et al. JACC Case Rep. .

Abstract

We present the case of a 55-year-old man who had a diagnosis of an acute anterior ST-segment elevation myocardial infarction. Emergency angiography demonstrated that both coronary systems originated from the right coronary sinus with a culprit proximal left anterior descending artery lesion, which was stented. This is a rare presentation, with only 1 similar case found in published reports. (Level of Difficulty: Intermediate.).

Keywords: CAA, coronary artery anomaly; CTA, computed tomography angiography; LAD, left anterior descending (artery); PCI, percutaneous coronary intervention; RCA, right coronary artery; STEMI, ST-segment elevation myocardial infarction; acute coronary syndrome; anomalous origination of a coronary artery from the opposite sinus; coronary artery anomaly; single coronary artery; sudden cardiac death.

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Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Invasive Coronary Angiography Images Pre-, During, and Post-LAD Stent Images in the (A and D) cranial right anterior oblique projection, (B) the cranial left anterior oblique projection, and (C) the caudal right anterior oblique projection demonstrating the left main coronary artery (green arrows) originating from the right coronary artery (white arrows) where it bifurcates into the left anterior descending (LAD) (red arrows) and left circumflex (blue arrows) arteries. (C and D) The left anterior descending artery after stent insertion.
Figure 2
Figure 2
Coronary CTA 3D Volume-Rendered Images of Coronary Anatomy Course Coronary computed tomography angiography (CTA) images in the (A) right anterior oblique projection, (B) posterior view, and (C) cranial view demonstrating the anomalous origin of the left main coronary artery (green arrow in B) from the inferior aspect of the right coronary artery ostium, taking a course posterior to the aortic root (green arrow in A) and emerging in the anterior interventricular groove (red arrow in C). The dominant right coronary artery is shown (white arrows in A to D). (D) Multiplanar image also demonstrating the same features. 3D = 3-dimensional; H = head; R = right.
See this image and copyright information in PMC

References

    1. Angelini P. Coronary artery anomalies: an entity in search of an identity. Circulation. 2007;115:1296–1305. - PubMed
    1. Angelini P. Coronary artery anomalies – current clinical issues: definitions, classification, incidence, clinical relevance, treatment guidelines. Tex Heart Inst J. 2002;29:271–278. - PMC - PubMed
    1. Kastellanos S., Aznaouridis K., Vlachopoulos C. Overview of coronary artery variants, aberrations and anomalies. World J Cardiol. 2018;10:127–140. - PMC - PubMed
    1. Villa A.D., Sammut E., Nair A. Coronary artery anomalies overview: the normal and the abnormal. World J Radiol. 2016;8:537–555. - PMC - PubMed
    1. Young P.M., Gerber T.C., Williamson E.E. Cardiac imaging: part 2, normal, variant, and anomalous configurations of the coronary vasculature. AJR Am J Roentgenol. 2011;197:816–826. - PubMed

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