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Cracking the Case of the Cryptic Coronary: Novel Diagnostic Strategies for Anomalous RCA Originating from Mid-LAD

Heart Science Journal · Vol. 5 No. 2 (2024) · hlm. 82–85

DOI
10.21776/ub/hsj.2024.005.02.15
ISSN
2721-9984, 2721-9976
Terbit
2024-04-28
Penerbit
Universitas Brawijaya
Bahasa
en

Abstrak

Background:Coronary artery anomalies are typically congenital, though they may remain undetected until routine cardiac catheterization is performed. With a detection rate of only 1.3%, these anomalies often go unnoticed. In rare cases, the right coronary artery may originate from the left coronary system, but this anomaly is generally benign, provided the vessel does not traverse the aorta and pulmonary artery.Case Illustration: A 55-year-old male patient was diagnosed with NSTEMI and underwent coronary angiography. However, the medical team was unable to cannulate into the right coronary ostium despite multiple attempts. The left coronary ostium was located in the left sinus of Valsalva. Selective left coronary arteriography revealed normal courses of the left main and LAD but identified a critical stenosis in the LCx and a possible CTO at the RCA ostium. The patient received a stent in the LCx and returned the following month for another angiography, during which he received a stent in the proximal LAD. However, during cine angiography, it was found that the patient had an anomalous RCA that originated from the mid-portion of LAD, coursing anteriorly to the pulmonary artery, and down to the right atrioventricular groove. Subsequent CCTA confirmed the RCA's origin from the mid-LAD.Conclusion:The report uncovers a unique occurrence where the RCA originates from the mid of the LAD. Appreciation to the integration of coronary CTA, a non-invasive imaging method, it is now feasible to conduct a comprehensive examination of the heart and its intricate vascular network. This, in turn, enables the development of effective surgical and interventional cardiovascular therapies. In a medical environment, this cutting-edge technology is particularly valuable for detecting and assessing coronary abnormalities.

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  • University of Brawijaya
  • RSUD Prof. Dr. Saiful Anwar Malang
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Rekan penulisOrganisasiArtikel bersama
Mohammad Saifur RohmanUniversity of Brawijaya17
Setyasih AnjarwaniUniversity of Brawijaya9
Cholid Tri TjahjonoUniversity of Brawijaya9
Indra PrasetyaUniversity of Brawijaya8
Djanggan SargowoUniversity of Brawijaya7
Sasmojo WiditoUniversity of Brawijaya7
Novi KurnianingsihUniversity of Brawijaya6
Anna Fuji RahimahUniversity of Brawijaya5
Muhammad Rizki FadlanUniversity of Brawijaya3
Ardian RizalUniversity of Brawijaya3
Valerinna Yogibuana Swastika PutriUniversity of Brawijaya3
Saskia Dyah HandariUniversity of Brawijaya3
Yoga WaranugrahaUniversity of Brawijaya2
Putri Annisa KamilaUniversity of Brawijaya2
Heny MartiniUniversity of Brawijaya2
Dea Arie KurniawanUniversity of Brawijaya2
Anna Fuji RahimahAfiliasi tidak diketahui2
Harris KristantoUniversity of Brawijaya2
Shalahuddin Suryo BaskoroUniversity of Brawijaya2
Muhammad Saifur RohmanAfiliasi tidak diketahui2
Merlita HerbaniUniversity of Brawijaya2
Yoseph Budi UtomoUniversity of Brawijaya1
Olivia HandayaniUniversity of Brawijaya1
Dadang HendrawanUniversity of Brawijaya1
Anita Surya SantosoUniversity of Brawijaya1
Hendrawati HendrawatiUniversity of Brawijaya1
Liemena Harold AdrianRSUD Prof. Dr. Saiful Anwar Malang1
Aditya Reza PratamaUniversity of Brawijaya1
Ayu Asri Devi AdityawatiUniversity of Brawijaya1
Imelda KrisnasariUniversity of Brawijaya1
Arief WibisonoAfiliasi tidak diketahui1
Bayu Purnomo AjiUniversity of Brawijaya1
Krishna Ari NugrahaAfiliasi tidak diketahui1
Seprian WidasmaraUniversity of Brawijaya1
Iskandar IskandarUniversity of Brawijaya1
Valerinna YogibuanaAfiliasi tidak diketahui1
Yudi Putra ApridityaUniversity of Brawijaya1
Andona Murni MaharaniAfiliasi tidak diketahui1

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Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">Cracking the Case of the Cryptic Coronary: Novel Diagnostic Strategies for Anomalous RCA Originating from Mid-LAD</dc:title>
	<dc:creator xml:lang="en">Indrihapsari, Pratiwi</dc:creator>
	<dc:creator xml:lang="en">Satrijo, Budi</dc:creator>
	<dc:subject xml:lang="en">Single coronary artery</dc:subject>
	<dc:subject xml:lang="en">Anomalous right coronary artery</dc:subject>
	<dc:subject xml:lang="en">CT coronary angiography</dc:subject>
	<dc:subject xml:lang="en">RCA from LAD</dc:subject>
	<dc:description xml:lang="en">Background:Coronary artery anomalies are typically congenital, though they may remain undetected until routine cardiac catheterization is performed. With a detection rate of only 1.3%, these anomalies often go unnoticed. In rare cases, the right coronary artery may originate from the left coronary system, but this anomaly is generally benign, provided the vessel does not traverse the aorta and pulmonary artery.Case Illustration: A 55-year-old male patient was diagnosed with NSTEMI and underwent coronary angiography. However, the medical team was unable to cannulate into the right coronary ostium despite multiple attempts. The left coronary ostium was located in the left sinus of Valsalva. Selective left coronary arteriography revealed normal courses of the left main and LAD but identified a critical stenosis in the LCx and a possible CTO at the RCA ostium. The patient received a stent in the LCx and returned the following month for another angiography, during which he received a stent in the proximal LAD. However, during cine angiography, it was found that the patient had an anomalous RCA that originated from the mid-portion of LAD, coursing anteriorly to the pulmonary artery, and down to the right atrioventricular groove. Subsequent CCTA confirmed the RCA's origin from the mid-LAD.Conclusion:The report uncovers a unique occurrence where the RCA originates from the mid of the LAD. Appreciation to the integration of coronary CTA, a non-invasive imaging method, it is now feasible to conduct a comprehensive examination of the heart and its intricate vascular network. This, in turn, enables the development of effective surgical and interventional cardiovascular therapies. In a medical environment, this cutting-edge technology is particularly valuable for detecting and assessing coronary abnormalities.</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2024-04-28</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/15280</dc:identifier>
	<dc:identifier>10.21776/ub/hsj.2024.005.02.15</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 5 No. 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases; 82-85</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2024.005.02</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/15280/411</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2024 Pratiwi Indrihapsari, Budi Satrijo</dc:rights>
</oai_dc:dc>