Coronary Artery Disease in Patient with An Anomalous Origin of Right Coronary Artery

Winda D. Nugraheni, Feranti Meuthia

Abstract

Coronary artery disease (CAD) remains a leading cause of mortality and morbidity in developed countries. CAD is a pathological process characterized by the accumulation of atherosclerotic plaques in the epicardial arteries, both obstructive and non-obstructive. This study aims to investigate rare cases of anomalous right coronary artery arising from the left main coronary artery and its clinical implications for coronary artery disease (CAD). The research methodology involved clinical examinations, echocardiography, diagnostic coronary angiography, and computed tomography angiography (CCTA) to obtain a comprehensive understanding of this case. The research findings indicate severe stenosis in the proximal-mid left main coronary artery (LAD) and an anomalous origin of the right coronary artery (RCA) leading to lower-level stenosis. Percutaneous coronary intervention (PCI) on the proximal-mid LAD lesion resulted in significant improvement in the patient's condition. The implications of this research underscore the importance of a deep understanding of coronary artery anatomical variations for accurate diagnosis and appropriate management of CAD patients, especially in rare cases like this.


 

Full text article

Generated from XML file

References

Ali, M., Hanley, A., McFadden, E. P., & Vaughan, C. J. (2011). Coronary artery anomalies: a practical approach to diagnosis and management. Heart Asia, 3(1), 8.
Angelini, P., & Monge, J. (2013). Coronary artery anomalies. Grossman & Baim’s Cardiac Catheterization, Angiography, and Intervention, 8th Ed. Lippincott Williams & Wilkins, pp. 335–353.
Bigler, M. R., Huber, A. T., Räber, L., & Gräni, C. (2021). A case report of a symptomatic right anomalous coronary artery with concomitant atherosclerotic disease: the benefit of a sequential, comprehensive non-invasive and invasive diagnostic approach. European Heart Journal-Case Reports, 5(3), ytab081.
De Filippo, M., & Capasso, R. (2016). Coronary computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR) imaging in the assessment of patients presenting with chest pain suspected of acute coronary syndrome. Annals of Translational Medicine, 4(13).
Gentile, F., Castiglione, V., & De Caterina, R. (2021). Coronary artery anomalies. Circulation, 144(12), 983–996.
Hong, L.-F., Luo, S.-H., & Li, J.-J. (2013). Percutaneous coronary intervention with anomalous origin of a right coronary artery: case reports and literature review. Journal of Geriatric Cardiology: JGC, 10(2), 205.
Knuuti, J., Wijns, W., Saraste, A., Capodanno, D., Barbato, E., Funck-Brentano, C., Prescott, E., Storey, R. F., Deaton, C., & Cuisset, T. (2020). 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: the Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). European Heart Journal, 41(3), 407–477.
Nakano, S., Kohsaka, S., Chikamori, T., Fukushima, K., Kobayashi, Y., Kozuma, K., Manabe, S., Matsuo, H., Nakamura, M., & Ohno, T. (2022). JCS 2022 guideline focused update on diagnosis and treatment in patients with stable coronary artery disease. Circulation Journal, 86(5), 882–915.
Narayanan, S. R., Al Shamkhani, W., & Rajappan, A. K. (2016). Anomalous origin of RCA from left coronary sinus presenting as PSVT and recurrent acute coronary syndromes. Indian Heart Journal, 68(2), 208–210.
Rawala, M. S., Longi, A. A., Khan, A. A., Rizvi, S. I., & Rizvi, S. B. (2019). A Case of an Anomalous Right Coronary Artery Arising from the Left Coronary Cusp. Cureus, 11(5). https://doi.org/10.7759/cureus.4659
Sechtem, U., Brown, D., Godo, S., Lanza, G. A., Shimokawa, H., & Sidik, N. (2020). Coronary microvascular dysfunction in stable ischaemic heart disease (non-obstructive coronary artery disease and obstructive coronary artery disease). Cardiovascular Research, 116(4), 771–786.
Shaban, M., Budhathoki, P., Bhatt, T., Lee, S., Neme, A. P. U., Guerra, M. A. R., & Zaw, M. (2022). Anomalous origin of the right coronary artery: an uncommon presentation. Cureus, 14(5).
Surhonne, P. S., Bogle, S. R. M., Bhairappa, S., & Gupta, A. K. (2016). Percutaneous coronary intervention in a case of anomalous single coronary artery. Case Reports, 2016, bcr2016215651.
Villa, A. D. M., Sammut, E., Nair, A., Rajani, R., Bonamini, R., & Chiribiri, A. (2016). Coronary artery anomalies overview: The normal and the abnormal. World Journal of Radiology, 8(6), 537.
Vora, K., Surana, U., & Ranjan, A. (2021). An unusual case of the single coronary artery with anomalous RCA from LAD: The ultimate of cardiac CT. IHJ Cardiovascular Case Reports (CVCR), 5(1), 17–21.

Authors

Winda D. Nugraheni
[email protected] (Primary Contact)
Feranti Meuthia

Article Details