Anomalous Right Coronary Artery Originating From the Left Anterior Descending Artery (original) (raw)

Diagnosis and percutaneous coronary intervention of an anomalous right coronary artery originating from the middle of the left anterior descending artery: a case report

Journal of International Medical Research

A single left coronary artery is a very rare anomaly in which only the left coronary artery arises from the aortic trunk by a single coronary ostium and supplies the entire heart. The present report is one of the few describing a patient with an anomalous right coronary artery originating from the middle of the left anterior descending artery. The patient presented with acute myocardial infarction with the culprit lesion on the left circumflex artery. Multivessel angioplasty was successfully performed in a two-step approach: the first for the culprit lesion and the second on the anomalous coronary artery. Decisions about treatment modalities for an anomalous coronary artery should be made only after considering the patient's clinical characteristics and performing additional imaging diagnostics with a clearly defined coronary anatomy.

Single Coronary Artery with Anomalous Rising of the Right Coronary Artery: A Rare Coronary Anomaly Diagnosed by 256-Multidetector Computed Tomography

Case Reports in Medicine, 2011

Herein we report the diagnostic potential of cardiac computed tomography (cCT) to delineate the origin and course of an anomalous right coronary artery (RCA) originating from the midpart of the left anterior descended artery (LAD) in an adult with no other form of congenital heart disease. The patient was referred to our institution due to exertional dyspnea and suspected coronary artery disease. The patient underwent X-ray coronary angiography, and no high grade lesions were observed in the left coronary vessels. In the course of the mid-left-anterior-descending artery (LAD), an anomalous side branch coursing away from the left circumflex coronary artery (LCX) was observed, while a right coronary ostium could not be depicted. cCT confirmed the absence of a right coronary ostium, and the vessel originating from the mid LAD was identified as an anomalous RCA, which coursed anterior of the aorta and the pulmonary trunk.

Anomalous right coronary artery arising next to the left coronary ostium

International Journal of Cardiology, 2010

Herein we report on the diagnostic potential of multi-detector row computed tomography (MDCT) combined with cardiovascular magnetic resonance (CMR) for the diagnostic workup in an adult patient with a rare coronary anomaly. MDCT unambiguously detected the anomalous right coronary artery (RCA), which originated next to the left coronary ostium and coursed inter-arterially between the ascending aorta and the pulmonary trunk. The intramural proximal intussusception of the ectopic RCA could be clearly appreciated on MDCT images, while multiple mixed plaques were detected in the left anterior descending (LAD), resulting in moderate stenosis of this vessel. CMR during adenosine infusion ruled-out inducible ischemia, yielding normal perfusion patterns both in the RCA and in the LAD coronary territory. Since ischemia was not demonstrated by stress CMR, revascularization was not performed.

An Anomalous Right Coronary Artery Draining into the Left Ventricle Through a Fistula

Journal of Clinical Medical Research, 2024

Background: Of the three main epicardial coronary arteries, the right coronary artery, left anterior descending artery, and the left circumflex artery, there are many variables between individuals regarding arterial course, distribution of side branches, and termination points. The term 'Coronary Artery Anomaly' (CAA) is reserved for congenital alterations in origin or course of the epicardial arteries that occur in less than 1% of the population. While the majority are asymptomatic, such anomalies can significantly increase the risk of myocardial ischemia and sudden cardiac death. With the increasing use of Coronary Computed Tomography Angiography (CCTA), the rate of detection of anomalous coronary arteries is increasing every year. The concurrent presence of a coronary cameral fistula further escalates clinical complexity requiring a multidisciplinary approach to management. Case Report: A 61-year-old female with a past medical history of hypertension, hypothyroidism, migraine, Non-Sustained Ventricular Tachycardia (NSVT), and Supraventricular Tachycardia (SVT), presented to the emergency department with chest pain and palpitations. Coronary angiography was performed revealing a large Right Coronary Artery (RCA) with a proximal branch giving rise to the Left Circumflex Artery (LCX), with an additional branch supplying the Left Anterior Descending (LAD) territory. The RCA and LCX arteries terminated distally in the left ventricular cavity forming a coronary cameral fistula. No flow-limiting stenosis was observed. Intervention versus medical management was discussed with a multidisciplinary team, and the decision was made to proceed with medical management. The patient's symptoms improved with the medical management. Conclusion: A thorough diagnostic evaluation and a multidisciplinary approach in managing rare coronary anomalies are critical. Medical management, risk factor modification, and regular follow-up are essential components of long-term care for patients with complex coronary artery anomalies.

An anomalous origin of left anterior descending coronary artery from right coronary artery in a patient with acute coronary syndrome

Journal of Tehran University Heart Center, 2011

A double left anterior descending (LAD) coronary artery emerging from the left and right coronary arteries is classified among rare coronary anomalies. We herein report a 73-year-old man presenting with acute coronary syndrome (posterolateral myocardial infarction). He was admitted with typical chest pain, and due to his progressive ischemic changes on electrocardiography (ECG) and elevated cardiac enzyme, he was candidated for cardiac catheterization. The coronary angiography revealed an anomalous LAD from the right sinus of Valsalva. The unusual coronary anatomy was perfectly matched with the distribution of ischemia and its clinical evidence on echocardiography and ECG. The culprit lesion was stented, and the patient was discharged in good physical condition from the hospital.

Left anterior descending coronary artery originating from the pulmonary artery: a rarity suspected during echocardiography

Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2008

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that is often referred to as Bland-White-Garland syndrome. Isolated anomalous origin of the left anterior descending (LAD) or circumflex arteries is even rarer. A 38-year-old woman presented with typical angina of about two-year history. Physical examination findings were normal other than a grade 3/6 systolic murmur. Electrocardiography showed anterolateral ST-segment depression and T wave inversion, indicating anterior ischemia. Color flow transthoracic Doppler echocardiography showed dilated coronary arteries. Parasternal short axis views demonstrated an abnormal flow originating from the common pulmonary artery. Upon suspicion of a coronary anomaly, coronary angiography was performed. Both the left circumflex (Cx) and right coronary arteries (RCA) were found dilated, giving extensive collaterals to the LAD artery, which drained into the main pulmonary artery. Computed tom...

Right Anomalous Coronary Artery Origin: The Role of Multislice CT Angiography

Indonesian Journal of Cardiology

Introduction: The anomalous origin of the right coronary artery (RCA) from the left coronary sinus coursing between the aorta and the pulmonary trunk is rare, but may cause myocardial ischemia and sudden death. Multislice CT coronaryangiography offers the possibility to visualize anomalous coronary artery origin non-invasively in details.Case Illustration: A 54-year-old man with a history of arterial hypertension, and hypercholesterolemia began to present with typical chest pain. After some non-invasive examination, he had coronary angiographythat revealed 70% stenosis at mid intermediate artery, normalLMCA, LAD and LCX. Ostium of RCA was found near the left valsava sinus afterrepeated cannulation attempts, no stenosis was found at RCA. After successful revascularization at intermediate artery, patient still had typical chest pain with positive ischemic response in treadmill test. Multislice CT coronary angiography was performedto evaluate the etiology of chest pain. The scan showed...