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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Anomalous left anterior descending artery: an uncommon cause of ST elevation myocardial infarction

Ali Raza Rajani1, Muhammad Anwer Rafiq1, Muhammad Hamid Mian1

  • 1Department of Cardiology, Rashid Hospital, Dubai Health Authority, Dubai, UAE.

BMJ Case Reports
|May 9, 2015
PubMed

Insights

A young man experienced severe chest pain due to ST-elevation myocardial infarction. Coronary angiography revealed an anomalous left anterior descending artery, a rare cause of heart attack in healthy individuals.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • ST-elevation myocardial infarction (STEMI) is a critical condition often caused by coronary artery atherosclerosis.
  • Anomalous coronary artery origins are rare congenital variations that can predispose individuals to myocardial infarction.

Observation:

  • A healthy 32-year-old man presented with acute anterior wall STEMI.
  • Initial ECG showed ST elevations, and cardiac biomarkers were elevated.
  • Echocardiography revealed an akinetic anterior segment of the left ventricle.

Findings:

  • Coronary angiography identified an anomalous left anterior descending artery originating from the right sinus of Valsalva.
  • No atherosclerotic lesions were found in the coronary arteries, ruling out typical causes of myocardial infarction.

Implications:

  • This case highlights anomalous coronary artery origin as a potential cause of myocardial infarction in young, healthy individuals.
  • It underscores the importance of comprehensive coronary angiography in diagnosing non-atherosclerotic causes of acute coronary syndromes.
  • Understanding these rare anatomical variations is crucial for accurate diagnosis and management of myocardial infarction.

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