Anomalous Left Main Coronary Artery From the Right Sinus of Valsalva
Hamza Chraibi1, Amina Samih1, Nouhaila Lahmouch1
1Cardiology B Department, Ibn Sina University Hospital, Mohammed V University, Rabat, MAR.
Insights
Anomalous origin of the left main coronary artery from the right sinus of Valsalva (LCA-RSV) is a rare condition. This case highlights its association with myocardial infarction and atherosclerotic disease.
Area of Science:
- Cardiology
- Anatomic Pathology
Background:
- Anomalous coronary arteries are uncommon congenital variations.
- Anomalous origin of the left main coronary artery from the right sinus of Valsalva (LCA-RSV) is a rare but potentially serious anomaly.
Observation:
- A 49-year-old male with type 2 diabetes and smoking history presented with acute chest pain.
- Diagnostic workup revealed inferior ST-elevation myocardial infarction (STEMI) and inferolateral left ventricular wall motion abnormalities.
Findings:
- Cardiac catheterization identified LCA-RSV.
- The patient also had significant atherosclerotic triple-vessel disease.
Implications:
- This case underscores the importance of considering rare coronary anomalies in patients with myocardial infarction, even with typical risk factors.
- Early diagnosis and appropriate management are crucial for preventing adverse cardiac events.
Abstract:
Anomalous coronary arteries are rare, mostly benign anatomic abnormalities. Anomalous origin of the left main coronary artery from the right sinus of Valsalva (LCA-RSV) is a rare variant that may lead to myocardial ischemia or sudden cardiac death. We present the case of a 49-year-old patient with a history of type 2 diabetes and smoking who presented to the emergency department with acute chest pain and was diagnosed with inferior ST-elevation myocardial infarction (STEMI). A transthoracic echocardiogram demonstrated inferolateral wall motion abnormalities of the left ventricle. The patient underwent cardiac catheterization that showed an anomalous left main coronary artery originating from the right sinus of Valsalva, alongside atherosclerotic triple-vessel disease. He was discharged home on medical management, including dual antiplatelet therapy, beta blockers, and statins, with scheduled follow-up.
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