Open AccessPosterior myocardial infarction caused by superdominant circumflex occlusion over an absent right coronary artery
Author(s) -
Seok Oh,
Ju Han Kim,
Min Chul Kim,
Young Joon Hong,
Youngkeun Ahn,
Myung Ho Jeong
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000026604
Subject(s) - medicine , right coronary artery , conventional pci , cardiology , circumflex , percutaneous coronary intervention , myocardial infarction , chest pain , artery , occlusion , coronary occlusion , coronary angiography
Rationale: Congenital agenesis of the right coronary artery (CARCA) initially presenting as acute myocardial infarction (AMI) due to total occlusion is a rare clinical condition that can lead to severe complications, including death. We report a case of successful percutaneous coronary intervention (PCI) in a patient with this condition. Patient concerns: A 57-year-old man was admitted to our center with chest pain that had occurred several hours prior. Since he was initially diagnosed with AMI with ST-segment elevation, we promptly commenced coronary angiography (CAG). Diagnosis: CAG revealed the absence of a right coronary artery (RCA). In the left coronary cusp area, the left circumflex coronary artery (LCX) was occluded totally. Interventions: We performed PCI for total occlusion of the proximal part of the LCX. Follow-up CAG showed a superdominant branch of the LCX, sprouting into the RCA territory. Outcomes: The patient was discharged uneventfully after successful PCI. Lessons: CARCA with AMI, which is an extremely unusual case, can be fatal; however, PCI seems to be an effective treatment option.