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Symptomatic right coronary anomaly with dynamic systolic intramural obliteration and isolated right ventricular ischemia
Author(s) -
Angelini Paolo,
Uribe Carlo
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28028
Subject(s) - medicine , cardiology , right coronary artery , stenosis , angina , asymptomatic , radiology , intravascular ultrasound , sinus (botany) , coronary angiography , botany , myocardial infarction , biology , genus
Abstract A 52‐year‐old man was referred for an anomalous right coronary artery (RCA) originating from the left sinus of Valsalva with an intramural course (R‐ACAOS‐IM), accompanied by progressive angina and dyspnea. He had been initially advised to have surgical treatment. Computerized axial tomographic angiography showed he had an ectopic origin from the left sinus of a small RCA, with a course between the aorta and pulmonary artery. His negative treadmill nuclear stress test was prematurely terminated because of angina and dyspnea. At our institution, intravascular ultrasound imaging indicated an intramural course and critically severe phasically changing proximal stenosis (80%–100%). The stenosis was resolved with stent‐angioplasty of the intramural segment. He had no complications and returned quickly to an asymptomatic state with unrestricted physical activity.