Inferior wall myocardial infarction caused by anomalous right coronary artery

Area of Science:

• Cardiology
• Cardiac Surgery
• Vascular Anatomy

Background:

• Congenital coronary artery anomalies are rare but can lead to significant cardiovascular events.
• Myocardial infarction (MI) in younger individuals without traditional risk factors warrants thorough etiological investigation.
• Anomalous origin of the right coronary artery is a recognized, albeit uncommon, coronary anomaly.

Observation:

• A 50-year-old male presented with inferior myocardial infarction post-exercise, with no prior history of coronary artery disease.
• Initial management included thrombolytic therapy and nitroglycerin.
• Coronary angiography and cardiac CT revealed an anomalous right coronary artery originating from the left coronary sinus, traversing between the aorta and main pulmonary artery.

Findings:

• The anomalous right coronary artery was identified as the likely cause of the exercise-induced myocardial infarction.
• The coronary arteries were otherwise patent, with no significant atherosclerotic disease.
• Transaortic unroofing of the anomalous right coronary artery was performed.

Implications:

• Surgical correction of anomalous coronary arteries can effectively resolve ischemic events.
• This case highlights the importance of advanced imaging in diagnosing coronary artery anomalies.
• Early diagnosis and surgical intervention for coronary artery anomalies can prevent adverse cardiac outcomes.