Pulmonary thromboembolism in a patient with an anomalous right coronary artery as a cause of unusual biventricular myocardial infarction.
This report presents the first case of an unusual biventricular myocardial infarction caused by pulmonary thromboembolism in a 55-year-old woman who had an anomalous origin of the right coronary artery (RCA) from the left coronary sinus. The RCA consequently courses between the aorta and pulmonary trunk, and dilatation of the pulmonary artery because of elevated pulmonary artery pressure compressed the proximal portion of the RCA. The consequent reduced right coronary oxygen supply and sudden increase in right ventricular afterload contributed to the characteristic right ventricular infarction, in addition to a left ventricular infero-posterior infarction. Her anginal symptoms disappeared following successful anticoagulation therapy and insertion of an inferior vena caval filter, without coronary bypass. This pathophysiologic phenomenon is rare, but can be fatal.
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Japan. notakeda-tky@umin.ac.jp
Norifumi
N
Takeda
Eiji
E
Ohtaki
Koichi
K
Kitahara
Masatoshi
M
Nagayama
Mika
M
Nagasaki
D003331:Coronary Vessels / Q000033:anatomy & histology*; D004562:Electrocardiography; D005260:Female; D006327:Heart Block; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D011655:Pulmonary Embolism / Q000175:diagnosis*