Brennan Emmett, Kahn Alexa B, Khan Abdullah, Chadow Hal L, Castillo Ricardo, Syed Rumman A, Ayinalem Yonael
Internal Medicine, One Brooklyn Health - Brookdale University Hospital Medical Center, Brooklyn, USA.
Cardiology, One Brooklyn Health - Brookdale University Hospital Medical Center, Brooklyn, USA.
Cureus. 2023 Aug 4;15(8):e42945. doi: 10.7759/cureus.42945. eCollection 2023 Aug.
Anomalous origin of the right coronary artery (RCA) is a rare congenital cardiovascular anomaly that can pose significant diagnostic challenges during cardiac evaluation. We present a case of a 54-year-old male patient with chest pain and a syncopal episode and subsequently diagnosed with non-ST-elevated myocardial infarction (NSTEMI). Coronary angiography revealed an anomalous origin of the RCA, making it difficult to precisely locate the artery's point of origin with selective contrast injection. During coronary angiography, the use of aortic root non-selective angiographic contrast injection aided in localizing the RCA ostium. Our case highlights the clinical significance of aortic contrast injection as a valuable and safe adjunctive technique in cases of anomalous coronary artery origins. Early detection and precise localization of such anomalies are essential for effective treatment planning and improved patient outcomes. Further studies may help validate the utility of aortic contrast injection in similar cases, thereby enhancing diagnostic accuracy and patient care in the management of anomalous coronary artery ostium.
右冠状动脉(RCA)异常起源是一种罕见的先天性心血管异常,在心脏评估过程中可能带来重大诊断挑战。我们报告一例54岁男性患者,有胸痛和晕厥发作,随后被诊断为非ST段抬高型心肌梗死(NSTEMI)。冠状动脉造影显示RCA起源异常,通过选择性造影剂注射难以精确确定动脉的起源点。在冠状动脉造影期间,使用主动脉根部非选择性血管造影剂注射有助于定位RCA开口。我们的病例强调了主动脉造影剂注射作为一种有价值且安全的辅助技术在冠状动脉异常起源病例中的临床意义。早期检测和精确定位此类异常对于有效的治疗规划和改善患者预后至关重要。进一步的研究可能有助于验证主动脉造影剂注射在类似病例中的效用,从而提高冠状动脉开口异常管理中的诊断准确性和患者护理水平。