Posterior myocardial infarction caused by superdominant circumflex occlusion over an absent right coronary artery: Case report and review of literature. Issue 27 (9th July 2021)

• Record Type: Journal Article
• Authors: Oh, Seok; Kim, Ju Han; Kim, Min Chul; Hong, Young Joon; Ahn, Youngkeun; Jeong, Myung Ho
• Editors: Saranathan., Maya
• Is Part Of: Medicine. Volume 100:Issue 27(2021)
• Page Start: e26604
• Publication Date: 2021-07-09
• Subjects: acute myocardial infarction -- percutaneous coronary intervention -- right coronary artery absence; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000026604
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Supplemental Digital Content is available in the text Abstract: Rationale: Congenital agenesis of the right coronary artery (CARCA) initially presenting as acute myocardial infarction (AMI) due to total occlusion is a rare clinical condition that can lead to severe complications, including death. We report a case of successful percutaneous coronary intervention (PCI) in a patient with this condition. Patient concerns: A 57-year-old man was admitted to our center with chest pain that had occurred several hours prior. Since he was initially diagnosed with AMI with ST-segment elevation, we promptly commenced coronary angiography (CAG). Diagnosis: CAG revealed the absence of a right coronary artery (RCA). In the left coronary cusp area, the left circumflex coronary artery (LCX) was occluded totally. Interventions: We performed PCI for total occlusion of the proximal part of the LCX. Follow-up CAG showed a superdominant branch of the LCX, sprouting into the RCA territory. Outcomes: The patient was discharged uneventfully after successful PCI. Lessons: CARCA with AMI, which is an extremely unusual case, can be fatal; however, PCI seems to be an effective treatment option.