Percutaneous Coronary Intervention in an Octogenarian With Anomalous Origin Arising From Right Sinus: A Rare Case...

Area of Science:

• Cardiology
• Interventional Cardiology
• Anatomical Variations

Background:

• Anomalous coronary artery origins are uncommon, affecting less than 1% of patients undergoing coronary angiography.
• Management challenges include delayed identification and difficulty engaging the anomalous vessel.

Observation:

• A case of acute inferior and posterior wall myocardial infarction (MI) is presented.
• The patient had an anomalous origin of the left circumflex artery from the right coronary sinus.
• This rare anomaly presented as ST-elevation myocardial infarction (STEMI) complicated by cardiogenic shock.

Findings:

• Percutaneous coronary intervention (PCI) in anomalous left circumflex arteries is technically demanding due to cannulation difficulties.
• Successful intervention requires prompt anomaly identification and appropriate catheter selection.
• STEMI with cardiogenic shock is an uncommon, high-risk presentation for this coronary anomaly.

Implications:

• Operator experience is critical for managing complex coronary anomalies.
• Early recognition and tailored interventional strategies are essential for improving patient outcomes.
• This case underscores the need for awareness and specialized skills in interventional cardiology for rare coronary artery variations.