scholarly journals Occlusion of the Right Ventricular Wall Branch of a Recessive Right Coronary Artery Resulting in Ventricular Fibrillation and Anterior ST-Segment Elevation—A Case Report

2020 ◽  
Vol 7 ◽  
Author(s):  
Harish Sharma ◽  
Sudhakar George
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Ventricular Fibrillation ◽  
Right Ventricular ◽  
Right Coronary Artery ◽  
Ventricular Wall ◽  
St Segment Elevation ◽  
St Segment ◽  
Right Ventricular Wall ◽  
The Right

Discriminating Between Right Coronary Artery and Circumflex Artery Occlusion by Using a Noninvasive 18-Lead Electrocardiogram

2007 ◽  
Vol 16 (1) ◽  
pp. 63-71 ◽  
Author(s):  
Shu-Fen Wung
Keyword(s):  
Coronary Artery ◽  
Right Ventricular ◽  
Right Coronary Artery ◽  
Coronary Occlusion ◽  
Atrioventricular Node ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary ◽  
The Right

• Background Differentiating occlusion of the circumflex branch of the left coronary artery (also called the circumflex artery) from occlusion of the right coronary artery is often difficult because either may be associated with a pattern of acute inferior myocardial infarction on the electrocardiogram. • Objectives To determine if an inexpensive 18-lead electrocardiogram can provide useful information in differentiating sites of coronary occlusion. • Methods Continuous 18-lead electrocardiograms, including standard 12-lead, right ventricular, and posterior leads, were recorded in 38 and 50 subjects undergoing percutaneous coronary interventions in the right coronary artery and the circumflex artery, respectively. • ResultsST-segment elevation in the posterior leads was twice as frequent during occlusion of the circumflex artery as during right coronary occlusion (P < .001). ST-segment elevation in the right ventricular leads and inferior leads occurred more often during occlusion of the right coronary artery than during occlusion of the circumflex artery. ST-segment depression in lead aVL is highly suggestive of right coronary occlusion, whereas ST-segment elevation in posterior leads without depression of the ST segment in lead aVL is highly sensitive and specific for occlusion of the circumflex artery. • Conclusions ST-segment changes in the 18-lead electrocardiogram can be used to differentiate between occlusions of the circumflex artery and occlusions of the right coronary artery. Knowing which vessel is occluded before percutaneous coronary intervention can help in planning the procedure and recognizing when patients are at high risk for disturbances in conduction at the atrioventricular node.

scholarly journals Anomalous origin of left main coronary artery from right coronary artery in a patient presenting with inferior wall myocardial infarction: a case report and literature review

2019 ◽  
Vol 3 (4) ◽  
pp. 1-6
Author(s):  
Dipesh Ludhwani ◽  
Vincent Woo
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Left Main Coronary Artery ◽  
Anomalous Origin ◽  
Single Coronary Artery ◽  
Inferior Wall ◽  
Left Main ◽  
St Segment Elevation ◽  
St Segment ◽  
The Right

Abstract Background Anomalous origin of the coronary arteries is seen 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. We present an extremely rare variant of the left main coronary artery (LMCA) branching off from the right coronary artery (RCA) and following a prepulmonic course. Case summary A 72-year-old woman presented due to ongoing chest pain with associated ST-segment elevation involving the inferior leads. Emergent cardiac catheterization revealed a 99% ulcerated lesion in distal RCA, which was intervened on with angioplasty and stent placement. The RCA was noted giving rise to LMCA, which followed a prepulmonic course (anterior to pulmonary artery) before trifurcating into a small caliber left anterior descending, ramus intermedius, and hypoplastic left circumflex arteries. The non-malignant course of the aberrant LMCA was confirmed on the coronary computed tomography angiogram. The patient was discharged home on guideline-directed medical therapy. Discussion The patient illustrated congenital SCA with type RIIA pattern of the aberrant vessel based on the Lipton anatomic classification for SCA. The prepulmonic course of SCA is usually benign and can be managed conservatively.

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