Abstract
Interesting case of anomalous origin of right coronary artery from left sinus.
Highlights
A 55-year-old male with a significant medical history of hypertension, hyperlipidemia, type 2 diabetes and gastroesophageal reflux disease presented to the emergency department with atypical cardiac chest pain
He complained of intermittent chest discomfort that had persisted for 2 months. He described the pain as 7 of 10 in severity, substernal, lasting less than 5 minutes, resolving spontaneously but becoming acutely worse with minimal exertion. His electrocardiogram (EKG) on presentation showed normal sinus rhythm with ST and T wave abnormalities potentially indicating anterior and inferior ischemia seen in III, avf, and V1-V3
Anomalous rcas that originate from the left coronary sinus occur in 0.05%-0.1% of the general population.[5]
Summary
He was admitted to cardiology for unstable angina and underwent a cardiac catheterization that showed tight lesions in both Left anterior descending and Left circumflex along with an anomalous RCA originating near the anterior left coronary artery sinus and coursing between the pulmonary artery and aorta. The patient was taken up for coronary artery bypass grafting and after complete recovery was discharged home.
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