A Rare Anomalous Origin of the Right Coronary Artery From Mid-Left Anterior Descending Artery: Do Not Rush Into
Karim Elbasha1, Stephan Fichtlscherer2, Holger Nef2
1Heart Centre, Segeberger Kliniken GmbH, Bad Segeberg, Germany; Cardiology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Insights
A rare single coronary artery anomaly, with the right coronary artery originating from the mid-left anterior descending artery, was diagnosed. Computed tomography angiography confirmed the diagnosis and is recommended for suspected coronary anomalies.
Area of Science:
- Cardiology
- Radiology
Background:
- Coronary artery anomalies are a significant cause of sudden cardiac death in young athletes.
- Limited evidence exists for managing symptomatic individuals with these anomalies.
Background:
Coronary artery anomalies represent the second leading cause of sudden cardiac death among young athletes, with limited evidence for the management of symptomatic individuals.
Case Summary:
We present a case of a single coronary artery anomaly; the right coronary artery (RCA) originating from the mid-left anterior descending artery (LAD). Further evaluation with stress imaging showed no evidence of stress-induced ischemia.
Discussion:
This represents a rare case of an anomalous origin and course of the RCA from the mid-LAD with a malignant interarterial course. The initial diagnosis was an ostial RCA chronic total occlusion with presumed retrograde filling from the LAD. However, a careful review of the angiogram demonstrated antegrade rather than retrograde flow. The diagnostic uncertainty was ultimately resolved by computed tomography coronary angiography.
Take-Home Message:
In case of suspected coronary anomalies or an unclear coronary course and/or origin, a computed tomography angiography is strongly recommended.
More Related Videos
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
11:07A Murine Model of Myocardial Ischemia-reperfusion Injury through Ligation of the Left Anterior Descending Artery
Published on: April 10, 2014
Related Concept Videos
Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
Physiology of the Heart: The Cardiac Cycle
Diastole: The Relaxation Phase
During diastole, all four heart chambers relax. The atrioventricular (AV) valves open, and the semilunar valves close. This phase sees the lowest chamber pressures, promoting ventricular filling. Venous blood enters the heart through the...
The Arch of Aorta
Encircling the heart, the coronary arteries form a ring-like structure before...
Cardiac Catheterization III: Left Heart Catheterization
Cardiac Catheterization II: Right Heart Catheterization
Thoracic Aorta
