Related Experiment Video

Updated: Jun 16, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

'Missing' coronary arteries at urgent coronary angiography for ST-elevation myocardial infarction

Marco Zimarino1, Luca Barnabei, Raffaele De Caterina

  • 1Institute of Cardiology and Center of Excellence on Aging, G d'Annunzio University, Chieti, Italy. m.zimarino@unich.it

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|January 23, 2010
PubMed

Insights

Anomalous coronary artery origins are rare findings in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention. Identifying these anomalies is crucial for accurate diagnosis and treatment during urgent angiography.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Radiology

Background:

  • Coronary artery anomalies are uncommon findings during coronary angiography.
  • ST-elevation myocardial infarction (STEMI) necessitates urgent intervention, often involving coronary angiography.
  • A 'missing' coronary artery in STEMI patients is typically assumed to be the occluded vessel.

Observation:

  • Two patients with inferior STEMI presented for primary percutaneous coronary intervention.
  • Urgent angiography revealed an anomalous origin of the left coronary system from the opposite sinus in both cases.
  • The anomalous origin was partial in one patient and complete in the other.

Findings:

  • Anomalous left coronary artery origin from the contralateral sinus in STEMI patients.
  • Misattribution of a 'missing' coronary artery due to anomalous origin.
  • Successful identification of coronary artery anomalies during urgent STEMI angiography.

Implications:

  • Accurate identification of coronary artery anomalies is critical in STEMI management.
  • Knowledge of these anomalies can prevent misdiagnosis and guide appropriate intervention.
  • Enhanced awareness of coronary artery anomalies improves patient outcomes in acute coronary syndromes.

More Related Videos

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft05:25

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft

Published on: September 15, 2023

Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...