Successful treatment of acute myocardial infarction associated with anomalous origin of coronary artery

The authors describe myocardial infarction in a 73-year-old patient. Urgent coronary angiography revealed a variant of anomalous origin of coronary artery (AOCA) (circumflex artery arising from the proximal part of the right coronary artery). Clinical, echocardiographic and angiographic data on acute myocardial infarction necessitated percutaneous coronary intervention with proximal right coronary artery stenting. Recovery period was uneventful with positive dynamics in clinical, electrocardiographic and laboratory parameters. The paper discusses the prevalence of coronary artery anomalies. The need for early detection of AOCA is emphasized because this anomaly may be associated with myocardial ischemia, cardiac arrhythmias and sudden cardiac death. The role of echocardiography in visualization of the so-called RAC-sign typical for retroaortic course of abnormally located CA is discussed separately. CT and coronary angiography are crucial for detecting AOCA.