Coronary artery anomalies presenting with ST-segment elevation myocardial infarction (original) (raw)
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Anomalous Coronary Artery Presenting with S-T Elevation Myocardial Infarction: A Case Report
Pakistan Journal of Cardiovascular Intervention
Background: Coronary artery anomalies are very rare congenital conditions. Rarely occurring but potentially fatal abnormalities of the coronary vasculature, abnormalities of the coronary arteries can cause significant cardiac events such as myocardial ischemia (S-T Segment elevation MI) and cardiac arrest. Case Presentation: We are presenting a case of a 60 years old hypertensive female patient who presented with ST-segment elevation in all precordial leads. Management & Results: On angiography, a giant right coronary artery was seen, and no Left coronary artery origin was not appreciated. Hence, Multidimensional CT angiography was done that showed dilated and ectatic left main coronary artery circulation originating from the pulmonary artery just above the pulmonary valve. The patient was declared a high-risk surgical candidate, was advised medical therapy, including beta blockers, dual antiplatelet, and antihyperlipidemic medications, and was advised to restrict physical activity....
2019
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Cardiology and Angiology: An International Journal
Coronary artery anomalies (CAAs) comprise a diverse group of congenital malformations with widely varying expressions and pathophysiological mechanisms. The most notable group of CAAs has been termed ‘Anomalous coronary artery originating from the opposite sinus of Valsalva’ (ACAOS), a rare congenital heart disease that is associated with sudden cardiac death and ischemia. We present the case of an 80-year-old man presenting with inferior STEMI having a single coronary ostium and a rare variant of the coronary artery origin belonging to type A4d with an interatrial LAD course according to Angelini's classification. This abnormal finding was managed conservatively and the patient underwent successful drug-eluding stent implantation in the culprit right coronary artery in its middle portion.
2019
Purpose: Anomalous Origin of Coronary Arteries from Opposite Sinus of Valsalva (ACAOS) is prevalent in 1% of the general and 0.4-0.7% of the imaging population. An Inter-Arterial Course (IAC) is considered to be associated with sudden cardiac death, particularly in young athletes predominantly related to anomalous left coronary artery originating from right sinus of Valsalva with IAC. The prognosis of Anomalous Right Coronary Artery from Left Sinus of Valsalva (R-ACAOS) with IAC is not clear. We aimed to assess the prevalence and the short-term prognosis of R-ACAOS in a Cardiac Computed Tomography Angiography (CCTA) population. Methods: This is a single centre retrospective cohort study encompassing 625 consecutive patients referred for CCTA for suspected Coronary Artery Disease (CAD) between January 2012 and December 2017. We found 10 cases of R-ACAOS with IAC. Each case was matched with two controls for age, gender, severity of CAD, cardiovascular risk factors, and history of reva...
Vojnosanitetski pregled
Introduction. Coronary artery anomalies are infrequent but anticipated findings during percutaneous coronary interventions (PCI). Compared to consistent reporting in angiographic series, they seem to be underreported in interventional studies, and particularly in the setting of primary PCI, where their prompt recognition is of the utmost importance. Case report. We present a 50 years old male with inferior ST-elevation of myocardial infarction (STEMI) and right ventricular involvement with solitary ostium for all three coronary arteries in the right aortic sinus of Valsalva. The patient had an extremely rare variant of coronary artery origination belonging to the type A4b2c2 of Angelini?s classification. Correspondingly, it belongs to the left Anomalous origination of a Coronary Artery from the Opposite Sinus of Valsalva (ACAOS) class with the intraseptal course of left anterior descending artery. We managed successfully to implant a drug eluting stent in the proximal right coronary...
The Egyptian Heart Journal, 2017
Congenital anomalies of the coronary arteries are a cause of sudden cardiac death. Of the known anatomic variants, anomalous origination of a coronary artery from an opposite sinus of Valsalva (ACAOS) remains a major clinical issue and a challenging condition to treat. Congenital coronary anomalies are likely to be under-recognized, as completing an anatomic assessment in a very large portion of the population would seem unfeasible. However, we present a case report with image of a 49 year old male presented with acute non-ST elevation ACS for which he underwent diagnostic angiography of the coronary system which revealed a common origin of both right and left main coronary artery from right sinus of Valsalva with significant obstructive lesion in the mid segment of right coronary artery. However, due to financial constraints CT angiography could not be done in this patient to identify the detail anatomy and the course of the anomalous left coronary artery origin (L-ACAOS). He was managed medically with dual antiplatelets, beta blockers, nitrates and ACE inhibitors.
Cardiology in Review, 2005
Congenital anomalies of the coronary arteries are a cause of sudden cardiac death. Of the known anatomic variants, anomalous origination of a coronary artery from an opposite sinus of Valsalva (ACAOS) remains a major clinical issue and a challenging condition to treat. Congenital coronary anomalies are likely to be under-recognized, as completing an anatomic assessment in a very large portion of the population would seem unfeasible. However, we present a case report with image of a 49 year old male presented with acute non-ST elevation ACS for which he underwent diagnostic angiography of the coronary system which revealed a common origin of both right and left main coronary artery from right sinus of Valsalva with significant obstructive lesion in the mid segment of right coronary artery. However, due to financial constraints CT angiography could not be done in this patient to identify the detail anatomy and the course of the anomalous left coronary artery origin (L-ACAOS). He was managed medically with dual antiplatelets, beta blockers, nitrates and ACE inhibitors.
Cureus
In multi-vessel coronary artery disease, concomitant ST-segment elevation myocardial infarction (STEMI) in simultaneous two culprit lesions have been rarely reported. In this regard, the recurrence in a short period of time of a STEMI in a different coronary artery is also rare. We describe the case of a 56-year-old male smoker, who was presented with an anterior STEMI. The coronary angiography demonstrated a significant lesion in the left main coronary (LMC) and an occlusion of the left anterior descending artery (LAD), and was referred for surgery. Four days later, he experienced symptoms of acute ischemia of the inferior territory. A newly formed culprit lesion of the circumflex artery (Cx) was detected and benefited from angioplasty. The patient expired the next day from sudden arrythmia. This case report shows two consecutive STEMI situations in separate coronary arteries, which commonly can occur in atherosclerotic patients with very poor prognosis.