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Four Coronary Arteries Separately Originating from the Right Sinus of Valsalva

Tatsuya Hondo1, Atsuo Mogami1, Shunsuke Miyauchi2

  • 1Department of Cardiology, Chugoku Rosai Hospital, Japan Organization of Occupational Health and Safety, Japan.

Internal Medicine (Tokyo, Japan)
|February 17, 2020
PubMed

Insights

This case report details a rare instance of quadriostial coronary artery origin in an 82-year-old woman presenting with heart failure. The unusual anatomy and atherosclerotic lesions contributed to her fatal outcome.

Area of Science:

  • Cardiology
  • Anatomical Pathology

Background:

  • Congenital coronary artery anomalies are rare but can lead to significant cardiovascular events.
  • Understanding variations in coronary artery origin and branching is crucial for accurate diagnosis and treatment.

Observation:

  • An 82-year-old female patient presented with heart failure.
  • Coronary angiography revealed a rare quadriostial origin, with three left coronary arteries (LCA-1, LCA-2, LCA-3) originating from the right sinus of Valsalva alongside a normal right coronary artery.
  • Detailed anatomical description of the anomalous left coronary arteries and their atherosclerotic lesions.

Findings:

  • The anomalous left coronary arteries exhibited an unusual course and branching pattern.
  • LCA-1 gave rise to septal branches and the obtuse marginal artery.
  • LCA-2 represented the main circumflex artery with an obstructive lesion, and LCA-3 was the distal anterior descending artery.

Implications:

  • This case highlights the importance of recognizing rare coronary artery anomalies, even in elderly patients.
  • Such anomalies, particularly with superimposed atherosclerosis, pose diagnostic and therapeutic challenges.
  • Accurate identification of coronary artery variations is vital for surgical planning and risk stratification.

Keywords:
coronary artery anomaliescoronary artery diseasedual left anterior descending arteriesquadriostial origintwin circumflex arteries

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