Othman Malek, Weisy Maimona, Al Smady Montaser, Hasan Ahmed, Hallak Yusuf, Alkowatli Hamza, Habboub Omar A, Hallak Ahmad
Internal Medicine, Bridgeport Hospital, Bridgeport, USA.
Medicine and Surgery, Istinye University, Istanbul, TUR.
Cureus. 2025 Aug 19;17(8):e90534. doi: 10.7759/cureus.90534. eCollection 2025 Aug.
Anomalous aortic origin of the right coronary artery (AAORCA) is a rare congenital anomaly. Although most patients with this anomaly remain asymptomatic, it is well established that this anomaly may lead to angina, myocardial infarction (MI), or sudden cardiac death (SCD) in the absence of atherosclerotic disease. In this article, we report three cases in the Middle East that presented with syncope in two patients, as well as diaphoresis and ECG changes during a nasal septoplasty surgery in the third. All patients were diagnosed with AAORCA with interarterial course using coronary computed tomography angiography (CTA) after initial evaluation. Although medical management varied over the three cases, all patients tolerated medical management and were referred for surgical interventions. One patient underwent a surgical procedure, with positive outcome afterwards. It is important to recognize the atypical presentations of the malignant course of AAORCA and demonstrate the importance of medical and surgical management in this disease, specially in understudied areas such as the Middle East.
右冠状动脉异常起源于主动脉（AAORCA）是一种罕见的先天性异常。尽管大多数患有这种异常的患者没有症状，但众所周知，在没有动脉粥样硬化疾病的情况下，这种异常可能导致心绞痛、心肌梗死（MI）或心源性猝死（SCD）。在本文中，我们报告了中东地区的三例病例，其中两例患者出现晕厥，第三例患者在鼻中隔成形术期间出现出汗和心电图变化。经过初步评估后，所有患者均通过冠状动脉计算机断层扫描血管造影（CTA）诊断为具有动脉间走行的AAORCA。尽管三例患者的医疗管理有所不同，但所有患者均耐受医疗管理并被转诊接受手术干预。一名患者接受了手术治疗，术后效果良好。认识到AAORCA恶性病程的非典型表现并证明医疗和手术管理在这种疾病中的重要性非常重要，特别是在中东等研究较少的地区。
