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Anomalous Right Coronary Artery from Left Main Coronary Artery and Subsequent Coursing between Aorta and Pulmonary

Deephak Swaminath1, Ragesh Panikkath1, Jason Strefling1

  • 1Department of Internal Medicine, TX Tech Health Sciences Center, Lubbock, TX 79430, USA.

Case Reports in Medicine
|January 24, 2014
PubMed

Insights

Anomalous coronary artery origin, a rare cause of sudden cardiac death in athletes, can be life-threatening. This case highlights a right coronary artery anomaly requiring coronary bypass surgery.

Area of Science:

  • Cardiovascular Medicine
  • Congenital Heart Disease

Background:

  • Anomalous origin of coronary arteries from the aorta is rare.
  • These anomalies can course between the aorta and pulmonary trunk, posing a risk.
  • Coronary artery anomalies are a leading cause of sudden cardiac death in young athletes.

Purpose of the Study:

  • To present a case of anomalous origin of the right coronary artery (RCA) from the left main coronary artery (LMCA).
  • To describe the specific anatomical course of the anomalous RCA between the pulmonary trunk and aorta.
  • To discuss the clinical presentation and management of this rare anomaly.

Main Methods:

  • Case report presentation.
  • Review of patient's clinical presentation, diagnostic imaging, and surgical intervention.
  • Discussion of relevant literature on coronary artery anomalies.

Main Results:

  • The patient presented with ST-elevation myocardial infarction (STEMI).
  • The anomaly involved the right coronary artery originating from the left main coronary artery.
  • The anomalous vessel coursed between the pulmonary trunk and aorta.
  • Coronary artery bypass surgery was performed.

Conclusions:

  • Anomalous coronary artery origin, particularly originating from the LMCA with interarterial coursing, is a critical condition.
  • Prompt diagnosis and surgical intervention, such as coronary bypass surgery, are crucial for managing associated ischemic events like STEMI.
  • This anomaly represents a significant risk factor for sudden cardiac death, especially in athletes.

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