Abstract
We describe an extremely rare case of a 37-year-old female patient who presented with
exertional angina and was diagnosed with a unique coronary anomaly with an anomalous
right coronary artery with origin in the left anterior descending artery and a fistula
between this anomalous coronary artery and the pulmonary artery.
Learning objectives
Most patients with coronary anomalies are asymptomatic but some may have angina caused
by a coronary steal phenomenon, myocardial infarction, or even sudden death depending
on the circuit and characteristics of the anomaly.
The combination of multiple coronary anomalies is extremely rare.
Despite being a rare diagnosis, coronary anomalies should always be considered as
a cause of myocardial ischemia, especially in young patients with low probability
for coronary obstructive disease.
Abbreviations:
ARCA (anomalous origin of the right coronary artery), CTA (computed tomography angiography), Cx (circumflex artery), ECG (electrocardiogram), ICA (invasive coronary angiography), LAD (left anterior descending coronary artery), LM (left main coronary artery), PA (pulmonary artery), PDA (posterior descending artery), RCA (right coronary artery), RI (ramus intermedius)Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Cardiology CasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Congenital coronary artery anomalies: a bridge from embryology to anatomy and pathophysiology - a position statement of the development, anatomy, and pathology ESC Working Group.Cardiovasc Res. 2016; 109: 204-216
- Anomalous right coronary artery originating from the left anterior descending artery: case report and review of the literature.Int J Cardiol. 2009; 137: 195-198
- 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes.Eur Heart J. 2020; 41: 407-477
- Coronary artery anomaly and sudden death - especially focus on anomalous left coronary artery arising from the right sinus.J Cardiol Cases. 2013; 7: e86-e88
- Coronary artery anomalies - current clinical issues: definitions, classification, incidence, clinical relevance, and treatment guidelines.Tex Heart Inst J. 2002; 29: 271-278
Article info
Publication history
Published online: May 19, 2022
Accepted:
April 18,
2022
Received in revised form:
April 10,
2022
Received:
February 4,
2022
Identification
Copyright
© 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. All rights reserved.
