Simonsen Hunter, Taylor Kaden, Brogan Luke, Reed Thaddeus, Geddes Taylor, Craig William
Medicine, Kansas City University of Medicine and Biosciences, Joplin, USA.
Cardiology, Mercy Hospital, Joplin, USA.
Cureus. 2025 Mar 16;17(3):e80653. doi: 10.7759/cureus.80653. eCollection 2025 Mar.
A 75-year-old male, with a history of hypertension and peripheral vascular disease, presented to the cardiac catheterization lab for an elective coronary angiogram after an abnormal cardiac stress test. The coronary angiogram results showed a total of four separate coronary artery ostia. Within the right coronary cusp, there were two separate ostia as opposed to a single ostia that supplies the right coronary artery (RCA). The additional ostia gave rise to the left anterior descending artery (LAD). Further, as opposed to the single ostia in the left coronary cusp, there were two separate ostia creating a left circumflex (LCX) and marginal artery. Despite this anomalous anatomy, the patient was asymptomatic and instructed to continue to follow up with outpatient cardiology. Our case report discusses this unique quadriostial coronary anatomy, the complications that can arise from anomalous coronary arteries, diagnoses, and management of such cases.
一名75岁男性，有高血压和外周血管疾病史，在心脏负荷试验异常后前往心导管实验室进行择期冠状动脉造影。冠状动脉造影结果显示共有四个独立的冠状动脉开口。在右冠状动脉瓣叶内，有两个独立的开口，而不是通常供应右冠状动脉（RCA）的单个开口。额外的开口发出左前降支动脉（LAD）。此外，与左冠状动脉瓣叶中的单个开口不同，有两个独立的开口形成左旋支动脉（LCX）和边缘动脉。尽管存在这种异常解剖结构，但患者无症状，并被指示继续在心内科门诊随访。我们的病例报告讨论了这种独特的四开口冠状动脉解剖结构、异常冠状动脉可能引发的并发症、此类病例的诊断和管理。
