Anomalous Origin of Left Main Coronary Artery from Right Coronary Artery in A Patient Presenting with Inferior Wall Myocardial Infarction: A Case Report

Mohammad Rafiur Rahman, Asma Akter, A. Mohiuddin, Sayedur R Khan, J. Kabir
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Abstract

Anomalous origin of the coronary arteries is a very rare phenomenon and is seen only in less than 1% of the general population. Single coronary artery (SCA) is a congenital anatomic abnormality identified by a single coronary ostium giving rise to one coronary artery. Our case presented at 40 years with intermittent chest discomfort, effort intolerance and a history of getting Streptokinase one month back due to AMI (Inferior). Diagnosis was confirmed with elective conventional coronary angiography and coronary CT angiography as an extremely rare variant of the left main coronary artery (LMCA) branching off from the right coronary artery (RCA) and then following a pre-pulmonic course. We did Off Pump CABG surgery with four grafts and discharged the patient uneventfully with guidelinedirected medical therapy with a beta-blocker, statin, and dual antiplatelet agents and the patient is on follow up. Bangladesh Heart Journal 2021; 36(1) : 61-66
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下壁心肌梗死患者左主冠状动脉与右冠状动脉异常起源1例
冠状动脉异常起源是一种非常罕见的现象,仅在不到1%的普通人群中可见。单冠状动脉(SCA)是一种先天性的解剖异常,由一个单一的冠状动脉口产生一个冠状动脉。我们的病例在40岁时提出间歇性胸部不适,努力不耐受和一个月前因急性心肌梗塞(AMI)接受链激酶治疗的历史。经选择性常规冠状动脉造影和冠状动脉CT血管造影证实为左主干冠状动脉(LMCA)从右主干冠状动脉(RCA)分叉,然后经过肺动脉前病程的一种极其罕见的变异。我们进行了4个移植物的停泵冠脉搭桥手术,患者顺利出院,并接受了-受体阻滞剂、他汀类药物和双重抗血小板药物的指导治疗,患者正在接受随访。孟加拉国心脏杂志2021;36(1): 61-66
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