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Malignant right coronary artery origin from the left sinus of Valsalva: Complementary role for transesophageal echocardiography upon the cath‐lab diagnosis
Author(s) -
Gregorio Cesare,
Ceresa Fabrizio,
Ferrazzo Giuseppe,
Patanè Francesco
Publication year - 2021
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22845
Subject(s) - medicine , cardiology , sinus (botany) , cardiac catheterization , right coronary artery , subclinical infection , radiology , myocardial ischemia , ischemia , left coronary artery , artery , coronary sinus , coronary angiography , myocardial infarction , botany , biology , genus
Anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva is a rare but clinically relevant congenital anomaly, since the RCA may be subjected to cyclical compression due to its interarterial course. At least in the past, most patients experienced bad outcomes before being diagnosed with a malignant variant. Chronic (often subclinical) myocardial ischemia and possible arrhythmias are common complications. Once symptoms or electrocardiographic signs of myocardial ischemia become apparent, a quick diagnosis is mandatory. We report the case of a late symptomatic woman in whom RCA originated from the opposite sinus of Valsalva. The malignant variant was confirmed at transesophageal echocardiography directly in the catheterization laboratory, soon after angiographic diagnosis of aberrant origin.