Acute Myocardial Infarction in a Patient with an Anomalous Origin of the Right Coronary Artery from the Left Anterior Descending Coronary Artery

Lee, Dong Yeol; Lee, Hye Jung; Kang, Sang Hyeon; Kim, Eun Seok; Lee, Dong Hyun; Park, Jong Sung; Kang, Eun-Ju

doi:2014.86.5.618

Korean J Med > Volume 86(5); 2014 > Article

Case Report

The Korean Journal of Medicine 2014;86(5):618-622.
Published online May 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.86.5.618

Acute Myocardial Infarction in a Patient with an Anomalous Origin of the Right Coronary Artery from the Left Anterior Descending Coronary Artery

Dong Yeol Lee¹, Hye Jung Lee¹, Sang Hyeon Kang¹, Eun Seok Kim¹, Dong Hyun Lee¹, Jong Sung Park¹, Eun-Ju Kang²

¹Departments of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
²Departments of Radiology, Dong-A University College of Medicine, Busan, Korea

좌전하행지에서 기원하는 우관상동맥을 가진 환자에서 발생한 심근경색

이동열¹, 이혜정¹, 강상현¹, 김은석¹, 이동현¹, 박종성¹, 강은주²

^¹동아대학교 의과대학 내과학교실
^²동아대학교 의과대학 영상의학과학교실

Correspondence:
Jong Sung Park, Tel: +82-51-240-5040, Fax: +82-51-240-5852, Email: thinkmed@dau.ac.kr

Received: 21 May 2013 • Revised: 18 June 2013 • Accepted: 22 July 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 55-year-old male underwent coronary artery intervention for an acute myocardial infarction of the inferior or lateral wall. The initial left coronary angiogram showed total occlusion of the proximal left circumflex artery (LCX). There was an abnormal coronary artery originating from the mid-portion of the left anterior descending artery (LAD) and running to the right ventricular side. However, we could not identify the anomalous right coronary artery (RCA). We tried to find the RCA in the right coronary cusp to confirm the infarction-related artery, but failed. A focused left coronary angiogram in the posteroanterior projection revealed the entire anatomy of the anomalous RCA. An anomalous origin of the RCA from the LAD is a rare coronary artery anomaly that might affect the physician’s decision during coronary intervention. We report an anomalous origin of the RCA from the mid-LAD and discuss the anatomy and clinical significance. (Korean J Med 2014;86:618-622)

Key Words: 관상동맥 기형; 심근경색증

주제어: 관상동맥 기형; 심근경색증