Journal of Lipid and Atherosclerosis  2015;4(2):131-135

doi:10.12997/jla.2015.4.2.131

Missing Right Coronary Artery in a Patient with Acute Inferior ST Segment Elevation Myocardial Infarction: A Case of Extremely Rare Variation of Coronary Anatomy.

Jae Hyuk LEE 1 ; Yongsung SUH ; In Cheol YOON ; Yong Hwan JUNG ; Sung Hwa CHOI ; Yun Hyeong CHO ; Deok Kyu CHO

Affiliations

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Keywords

Coronary vessel anomalies; Myocardial infarction; Percutaneous coronary intervention

Country

Republic of Korea

Language

English

Abstract

We recently encountered an interesting case of acute inferior ST segment elevation myocardial infarction (STEMI). This patient had a rare anatomic variation, single coronary artery. The right coronary artery originate from the left circumflex proper artery, not from aorta, was totally obstructed with thrombi. Though it took more time to figure out the patient's coronary anatomy and the culprit lesion, we successfully performed primary percutaneous coronary intervention within the guideline-recommended time period. We performed left coronary angiography at the beginning. This strategy could be helpful in determining the culprit lesion and preventing unnecessary procedural delay in acute inferior STEMI.