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Case Report

IJMDC. 2023; 7(11): 1582-1585

Anomalous left main from right coronary artery who presented with NSTEMI

Asim Mohammed Waleed Aldorrah, Mosa Mohammad Abbadi, Mohsen Jaber Alotayfi, Mohammed Nasser Asiri.


Background: Coronary artery anomalies (CAAs) are found in 0.9%-1.3% of patients undergoing coronary angiography. The most common CAAs are anomalies of origin, specifically having a separate left circumflex (LCX) and left anterior descending (LAD) origin with an incidence of 0.41%. Based on the 12-lead standard electrocardiography (ECG) recording, patients are divided into ST elevation myocardial infarction or non-ST-elevation acute myocardial infarction (NSTEMI).
Case presentation: Here, we present our case of a 90 years old male patient who presented with non-STEMI and was found to have an anomalous origin of LAD and LCX from the right coronary artery (RCA). The patient was admitted to the critical care unit as a case of NSTEMI and started on anti-ischemic therapy.
Conclusion: Our patient had two coronary anomalies detected: an LCX artery originating from the RCA, and an anomalous LAD originating from the RCA. The ECG showed NSTEMI.

Key words: Coronary artery anomalies, anomalous left circumflex, left anterior descending, non-ST-elevation acute myocardial infarction.

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