Chest Pain on Exertion: Origin of the Right Coronary Artery from the Left Coronary Sinus, through the Aortic Pulmonary Sulcus with Squeezed, or Anterior Descending Branch Borderline Coronary Lesion? - Case Reports in Clinical Medicine

CRCM > Vol.4 No.4, April 2015

Chest Pain on Exertion: Origin of the Right Coronary Artery from the Left Coronary Sinus, through the Aortic Pulmonary Sulcus with Squeezed, or Anterior Descending Branch Borderline Coronary Lesion? ()

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DOI: 10.4236/crcm.2015.44030 2,947 Downloads 4,570 Views

Author(s)

Jun Luo, Zhihong Zhao^*, Chan Jin, Xinming Li^*

Affiliation(s)

Department of Cardiology, ZhouPu Hospital, Shanghai, China.

ABSTRACT

The prognosis of patients in whom the right coronary artery (RCA) arises from the left coronary sinus (LCS) is unequal. An initial intramural course of the coronary artery within the aortic media is considered to cause myocardial ischemia in cases of coronary anomalies. In this case report, we present one patient admitted due to chest pain on exertion that suggested angina. Her only risk factor for coronary artery disease was hypertension. Clinical examination findings that the origin of the right coronary artery from the LCS, through the aortic pulmonary sulcus with atherosclerotic narrowing and squeezed of the RCA critical ostial, stenosis at the ostium of the RCA and the middle of left anterior descending (LAD) coronary, intravascular ultrasonography (IVUS) showed LAD and RCA minimal lumen area were 3.9 mm2, 5.9 mm2; plaque burden 66%, 65% respectively. We inserted EXCEL 3.0 × 18 mm stent in LAD stenosis. No complaints and adverse events were noticed during a 1-year follow-up.

KEYWORDS

Anomalous Right Coronary Artery, Left Sinus of Valsalva, Intravascular Ultrasonography

Share and Cite:

Luo, J. , Zhao, Z. , Jin, C. and Li, X. (2015) Chest Pain on Exertion: Origin of the Right Coronary Artery from the Left Coronary Sinus, through the Aortic Pulmonary Sulcus with Squeezed, or Anterior Descending Branch Borderline Coronary Lesion?. Case Reports in Clinical Medicine, 4, 141-144. doi: 10.4236/crcm.2015.44030.

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