Anomalous Coronary Artery Presenting with S-T Elevation Myocardial Infarction: A Case Report

Authors

  • Mukesh Kumar National Institute of Cardiovascular Diseases (NICVD), Karachi-Pakistan.
  • Rizwan Qurban Ali Khawaja National Institute of Cardiovascular Diseases (NICVD), Karachi-Pakistan.
  • Fawad Farooq National Institute of Cardiovascular Diseases (NICVD), Karachi-Pakistan.
  • Abdul Hakeem National Institute of Cardiovascular Diseases (NICVD), Karachi-Pakistan.
  • Atif Sher Muhammad Karachi Institute of Heart Diseases, Karachi-Pakistan.

Keywords:

Coronary Artery Anomaly, Giant Right Coronary Artery, Multidimensional CT Angiography, Pulmonary Artery, S-T Segment

Abstract

Background: Coronary artery anomalies are very rare congenital conditions. Rarely occurring but potentially fatal abnormalities of the coronary vasculature, abnormalities of the coronary arteries can cause significant cardiac events such as myocardial ischemia (S-T Segment elevation MI) and cardiac arrest.

Case Presentation: We are presenting a case of a 60 years old hypertensive female patient who presented with ST-segment elevation in all precordial leads.

Management & Results: On angiography, a giant right coronary artery was seen, and no Left coronary artery origin was not appreciated. Hence, Multidimensional CT angiography was done that showed dilated and ectatic left main coronary artery circulation originating from the pulmonary artery just above the pulmonary valve. The patient was declared a high-risk surgical candidate, was advised medical therapy, including beta blockers, dual antiplatelet, and antihyperlipidemic medications, and was advised to restrict physical activity.

Conclusion: The rare presentation of an aberrant coronary artery is myocardial infarction with ST-segment elevation, and it might be difficult for doctors and cardiologists to determine the true reason without intervention. To optimize the care of these patients, traditional CAA and MDCT must be integrated with the clinical presentation of the patient.

References

Ogden JA. Congenital anomalies of the coronary arteries. Am J Cardiol. 1970;25(4):474-9.

Roberts WC. Major anomalies of coronary arterial origin seen in adulthood. Am Heart J. 1986;111(5):941-63.

Keswani AN, Dann K, Ramee S. Anomalous right coronary artery: a case report. Ochsner J. 2014;14(2):287-91.

Alexander RW, Griffith GC. Anomalies of the coronary arteries and their clinical significance. Circulation. 1956;14(5):800-5.

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Published

01-06-2022

How to Cite

Kumar, M. ., Khawaja, R. Q. A. ., Farooq, F. ., Hakeem, A. ., & Muhammad, A. S. . (2022). Anomalous Coronary Artery Presenting with S-T Elevation Myocardial Infarction: A Case Report. Pakistan Journal of Cardiovascular Interventions, 2(1), 40–44. Retrieved from https://www.pjcvi.com/index.php/home/article/view/36