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Article

“Coronary Confusion” Congenital Anomaly of the Left Main Coronary Artery Presenting as a Myocardial Infarction in a Young Female

1Department of Internal Medicine, State University of New York: Downstate Medical Center, Brooklyn, New York, United States-11203

22Department of Pediatrics, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States-77555

3Department of Pediatrics, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States-77555


American Journal of Medical Case Reports. 2019, Vol. 7 No. 3, 41-45
DOI: 10.12691/ajmcr-7-3-3
Copyright © 2019 Science and Education Publishing

Cite this paper:
Mohammed Al-Sadawi, Hope A. Taitt, Michael Haddadin, Shakil Shaikh, Murad Almasri, Angeleque Hartt, Samy I. McFarlane. “Coronary Confusion” Congenital Anomaly of the Left Main Coronary Artery Presenting as a Myocardial Infarction in a Young Female. American Journal of Medical Case Reports. 2019; 7(3):41-45. doi: 10.12691/ajmcr-7-3-3.

Correspondence to: Samy  I. McFarlane, Department of Internal Medicine, State University of New York: Downstate Medical Center, Brooklyn, New York, United States-11203. Email: smcfarlane@downstate.edu

Abstract

Coronary artery anomalies are rare congenital disorders occurring in 0.3-5.6 % of the population. However, it carries a potential risk of sudden death in young athletes due to the development of premature coronary artery disease. The diagnosis of coronary artery anomalies is usually made incidentally; commonly found while investigating other cardiac conditions. A coronary CT angiography and traditional interventional angiography are the gold standards for diagnosing congenital coronary artery anomalies. Here, we present a case of a 27 year-old female with a history of hypertension and membranous glomerulonephritis with proteinuria presenting with an inferior ST elevation myocardial infarction. Cardiac catheterization revealed an anomalous origin of the left anterior descending artery from the right coronary cusp and absence of the left circumflex artery with a super-dominant right coronary artery. The patient had an occlusion of the right posterior descending artery and the right posterolateral segment. We discuss the clinical diagnosis and intervention of the case along with review of the literature.

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