Anteriorly displaced right coronary artery in acute myocardial infarction: What should every cardiologist know

Edo Kaluski, Pallavi Solanki, Monica Sanchez Shields, Muhamed Saric, Preet Randhawa, Marc Klapholz, Bunyad Haider, Christine Gerula

Research output: Contribution to journalArticle

Abstract

Anteriorly displaced right coronary artery (RCA) and anomalous origin RCAs occur in ≈1% and 0.1% of adult patients, respectively, and are the leading cause of incomplete coronary angiography and prolonged procedure times. We present a case in which anteriorly displaced RCA occlusion resulted in an acute inferior-posterior-right ventricular myocardial infarction complicated by complete atrioventricular block and hypotension. Failure to image the RCA resulted in considerable delay in reperfusion time with fibrinolysis.The authors discuss the most frequent anatomic locations of ectopic RCAs and suggest an algorithm to be employed when an ectopic RCA cannot be imaged with conventional diagnostic catheters. Contrary to popular belief, the search for an ectopic RCA has <90° boundaries limited to the anterior third of the right sinus and anterior half of the left sinus.

Original languageEnglish (US)
Pages (from-to)59-64
Number of pages6
JournalCardiovascular Revascularization Medicine
Volume12
Issue number1
DOIs
StatePublished - Jan 1 2011

Keywords

  • Anomalous coronary artery
  • Computed tomography
  • Coronary angiography
  • Echocardiography
  • Myocardial infarction
  • Right coronary artery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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