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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 right coronary artery arising from left coronary cusp with coexisting valvular heart disease

Akash Khetpal1, Neelam Khetpal2, Ansab Godil1

  • 1Dow University of Health Sciences, Karachi, Pakistan.

JPMA. the Journal of the Pakistan Medical Association
|April 29, 2016
PubMed

Insights

This case study highlights a rare congenital heart anomaly: an abnormal right coronary artery originating from the left coronary cusp. This unusual coronary artery variation was incidentally found alongside severe aortic stenosis in a hypertensive patient presenting with chest pain.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Interventional Cardiology

Background:

  • A 50-year-old female with hypertension presented with symptoms of ischaemic heart disease (IHD).
  • Standard diagnostic workup included echocardiography and coronary angiography.
  • Hypertension is a significant coronary risk factor.

Observation:

  • The patient exhibited an abnormal origin of the right coronary artery from the left coronary cusp.
  • Echocardiography showed poor progression of R waves and severe aortic stenosis with aortic root dilatation.
  • The coronary artery anomaly was an incidental finding during angiography.

Findings:

  • Simultaneous presentation of anomalous coronary artery origin and severe valvular pathology (aortic stenosis).
  • Ischaemic heart disease (IHD) diagnosis in the context of hypertension and coronary anomaly.
  • Aortic root dilatation noted on echocardiography.

Implications:

  • This case underscores the importance of recognizing rare coronary artery anomalies.
  • Simultaneous detection of valvular disease and coronary anomalies can impact clinical management.
  • Highlights the diagnostic value of coronary angiography in identifying incidental cardiac findings.

Keywords:
Right coronary artery, Left coronary cusp, Aortic stenosis.

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