title: Management of subacute myocardial infarction in a patient with left coronary artery originating from the right coronary artery.
abstract: Although the majority of coronary artery anomalies are found incidentally and not clinically significant, the interarterial course between the major vessels of the aberrant artery may be responsible for syncope, angina, arrhythmias or sudden death. There are only a few case reports describing the origination of all the coronary arteries from a single ostium. This anomaly occurs in only 0.024%-0.044% of the population. Left coronary artery originating from the right coronary is a rare coronary abnormality. Here we report a case of acute myocardial infarction in a patient with anomalous left coronary artery originating from the right coronary artery, as was confirmed by computerized tomography angiogram, which showed that only one single coronary artery stem originating from the right sinus of Valsalva trifurcated into a right coronary artery, left circumflex artery and a hypoplastic left anterior descending artery. Subsequent percutaneous coronary intervention (PCI) procedures were performed successfully. PCI procedures should be carried out with great caution in such cases, and this condition should be managed as a left main lesion.
authors.affiliation: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China. zhouzhongjiang@126.com
authors.forename: Zhong-jiang
authors.initials: ZJ
authors.lastname: Zhou
authors.forename: Bundhoo
authors.initials: B
authors.lastname: Kaviraj
authors.forename: Shi-ping
authors.initials: SP
authors.lastname: Cao
authors.forename: Yue-gang
authors.initials: YG
authors.lastname: Wang
authors.forename: Zhen
authors.initials: Z
authors.lastname: Huang
authors.forename: Zhi-gang
authors.initials: ZG
authors.lastname: Guo
authors.forename: Ding-li
authors.initials: DL
authors.lastname: Xu
authors.forename: Yu-qing
authors.initials: YQ
authors.lastname: Hou
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D062645:Percutaneous Coronary Intervention