Open AccessPercutaneous Coronary Intervention in an Octogenarian With Anomalous Origin Arising From Right Sinus: A Rare Case Report
Author(s) -
Yeriswamy Mogalahally Channabasappa,
Natraj Setty,
Sandeep Shankar,
Ravindranath Kandenahalli Shankrappa,
Jayashree Kharge,
Raghu Thagachagere Ramegowda,
Rahul Patil,
Sathish Kerur,
Manjunath Cholenahally Nanjappa
Publication year - 2020
Publication title -
journal of medical cases
Language(s) - English
Resource type - Journals
eISSN - 1923-4163
pISSN - 1923-4155
DOI - 10.14740/jmc3429
Subject(s) - medicine , percutaneous coronary intervention , coronary sinus , sinus (botany) , percutaneous , cardiology , radiology , myocardial infarction , botany , biology , genus
Anomalous coronary artery origins are not common in routine clinical practice. The incidence of coronary anomalies in patients undergoing coronary angiography is less than 1%. The greatest challenges faced in the management are delays in identification and difficulty engaging the anomalous coronary artery. Operator experience in promptly identifying the anomaly and selection of the appropriate catheter is critical for successful intervention. We are presenting a case of acute inferior and posterior wall myocardial infarction (MI) with an anomalous origin of the left circumflex artery from the right coronary sinus. Learning objective is that percutaneous coronary intervention (PCI) in an anomalous left circumflex can be technically difficult because selective cannulation of the vessel may not be easy. An anomalous left circumflex artery has a rare presentation of ST-elevation myocardial infarction (STEMI). Complicated STEMI with cardiogenic shock is not commonly seen in anomalous coronary artery origin from the right sinus. Percutaneous intervention in patients with STEMI with an anomalous left circumflex artery has a high risk and is technically challenging.