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Acute myocardial infarction caused by "malignant" anomalous right coronary artery detected by multidetector row

Minoru Ichikawa1, Sei Komatsu, Hiroshi Asanuma

  • 1Cardiovascular Division, Kawachi General Hospital, Higashi-osaka, Osaka, Japan. ichikawa@kawati.org

Circulation Journal : Official Journal of the Japanese Circulation Society
|November 26, 2005
PubMed

Insights

Malignant coronary artery anomalies can cause sudden cardiac events. This case report details a patient with anomalous right coronary artery origin, diagnosed using advanced imaging, revealing the cause of their myocardial infarction.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Anomalous coronary arteries are often incidental findings.
  • Certain malignant coronary anomalies are linked to severe cardiac events like myocardial infarction and sudden death.
  • Pathogenesis of these events has historically relied on autopsy findings.

Observation:

  • A patient presented with acute myocardial infarction.
  • The patient had an anomalous origin of the right coronary artery from the left sinus of Valsalva.
  • Multidetector row computed tomography and intravascular ultrasound were utilized.

Findings:

  • Advanced imaging successfully visualized the anomalous coronary artery.
  • The culprit plaque responsible for the myocardial infarction was identified.
  • This case demonstrates the utility of non-invasive imaging in evaluating malignant coronary anomalies.

Implications:

  • Multidetector row computed tomography and intravascular ultrasound can effectively diagnose coronary anomalies and associated pathologies.
  • These imaging modalities offer a detailed view of the culprit lesion, aiding in understanding the mechanism of myocardial infarction in anomalous coronary arteries.
  • This approach provides valuable insights beyond traditional autopsy methods for managing patients with high-risk coronary anomalies.

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