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All Journal Cardiovascular and Cardiometabolic Journal (CCJ)
Imam Mahbub Zam Zami
Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology

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Inferior Myocardial Infarction and Total AV Block in a Patient with Single Ostium in the Right Sinus of Valsava (A Rare Congenital Coronary Anomaly) Imam Mahbub Zam Zami
Cardiovascular and Cardiometabolic Journal Vol. 2 No. 1 (2021): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v2i1.2021.36-40

Abstract

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.
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