Anomalous Origin of the Left Coronary Artery From the Right Coronary Cusp: A Case Report.
| Autor: | Shtembari J; Department of Internal Medicine, Mount Sinai Hospital, Chicago, USA., Shrestha DB; Department of Medicine, Mount Sinai Hospital, Chicago, USA., Oli PR; Department of Medicine, Province Hospital, Surkhet, NPL., Munagala A; Department of Cardiology, Mount Sinai Hospital, Chicago, USA., Mullaj E; Department of Cardiology, Mount Sinai Hospital, Chicago, USA., Shehata K; Department of Cardiology, Mount Sinai Hospital, Chicago, USA., Kovacs D; Department of Cardiology, Mount Sinai Hospital, Chicago, USA., Khosla S; Department of Cardiology, Mount Sinai Hospital, Chicago, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2023 Mar 03; Vol. 15 (3), pp. e35711. Date of Electronic Publication: 2023 Mar 03 (Print Publication: 2023). |
| DOI: | 10.7759/cureus.35711 |
| Abstrakt: | Anomalous origin of the left main coronary trunk from the right coronary sinus is a rare condition and is associated with a significantly increased risk of cardiac events, including sudden cardiac death, and it may pose difficulties in their management using revascularization strategies. We present a case of a 68-year-old man with worsening chest pain. Initial evaluation revealed ST elevation of the inferior wall leads and elevated troponins. He was diagnosed with ST-elevation myocardial infarction (STEMI) and sent for emergency cardiac catheterization. Coronary angiography showed 50% stenosis of the mid-right coronary artery (RCA) that extended as a total occlusion to the distal RCA and an unexpected anomalous origin of the left main coronary artery (LMCA). Our patient's LMCA originated from the right cusp sharing a single ostium with the RCA. Multiple attempts of revascularization with percutaneous coronary intervention (PCI), using multiple wires, catheters, and different-sized balloons, were unsuccessful due to complex anatomy. Our patient was managed with medical therapy and discharged home with close cardiology follow-up. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Shtembari et al.) |
| Databáze: | MEDLINE |
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