Inferior Myocardial Infarction and Total AV Block in a Patient with Single Ostium in the Right Sinus of Valsava (A Rare Congenital Coronary Anomaly)

Authors

Imam Mahbub Zam Zami
zamzamimahbub@gmail.com
Cardiology and Vascular Department, Airlangga University

Vol. 2 No. 1 (2021): Cardiovascular and Cardiometabolic Journal

Case Report

March 27, 2021

Versions

2021-03-27 (2)
2021-03-27 (1)

A 51-year-old male suffered from a STEMI inferior and a total AV block. Echocardiography shows hypokinetic wall motion at the inferior and inferoseptal that result in decreased EF. Coronary angiography revealed a single ostium of coronary artery without any stenosis. Cardiac CT revealed a single coronary artery arises from a single ostium from RCC and divided into RCA and LCA. There was an inter-arterial course of proximal RCA and proximal LCA between aorta and pulmonal artery. There was an acute angle take off of RCA from aorta. Inter-arterial course and acute angle take off of coronary artery from aorta result in kinking and narrowing of coronary artery that contributes to myocardial infarction. There is a mismatch between myocardial demand which is increased during exertion and myocardial oxygen delivery that decreased during exertion. A surgical anterior pulmonal transposition is the suggested choice of therapy.

Zam Zami, I. M. (2021). Inferior Myocardial Infarction and Total AV Block in a Patient with Single Ostium in the Right Sinus of Valsava (A Rare Congenital Coronary Anomaly). Cardiovascular and Cardiometabolic Journal (CCJ), 2(1), 36–40. https://doi.org/10.20473/ccj.v2i1.2021.36-40

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