Double right coronary artery in primary PCI: Finding the hidden treasure…
Luciano Candilio1, Roberto Nerla1, Jonathan Byrne1
1King's College Hospital, Cardiac Department, London, UK.
Insights
Double Right Coronary Artery (RCA) is a rare anomaly. This case highlights its potential association with inferior ST-segment elevation myocardial infarction (STEMI), emphasizing the need for careful diagnosis.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Interventional Cardiology
Background:
- Double Right Coronary Artery (RCA) is a rare congenital coronary anomaly.
- While often benign, it has been linked to severe cardiac events like myocardial infarction and sudden death.
- The direct causal role of double RCA in these acute presentations remains unclear.
Abstract:
Double Right Coronary Artery (RCA) is one of the rarest congenital coronary anomalies. Although it can be regarded as a benign condition in the vast majority of cases, it has been associated with acute and life-threatening presentations, including inferior ST-segment elevation myocardial infarction (STEMI), cardiogenic shock and complete heart block, tachyarrhythmias, or even sudden death. However, the role of a double RCA in these conditions is yet to be clarified as more recent data prove no statistically significant association between prevalence of significant atherosclerosis in anomalous coronary arteries in comparison to normal coronary arteries. Here we present a case of inferior STEMI in the context of double RCA, in which one of the two component branches was accidentally found after an "unexpected" jump of the coronary guidewire to treat what was initially considered the main vessel.
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