Double right coronary artery in primary PCI: Finding the hidden treasure…

Cardiovasc Revasc Med. 2017 Dec;18(8):601-603. doi: 10.1016/j.carrev.2017.06.015. Epub 2017 Jul 5.

Abstract

Double Right Coronary Artery (RCA) is one of the rarest congenital coronary anomalies. Although it can be regarded as a benign condition in the vast majority of cases, it has been associated with acute and life-threatening presentations, including inferior ST-segment elevation myocardial infarction (STEMI), cardiogenic shock and complete heart block, tachyarrhythmias, or even sudden death. However, the role of a double RCA in these conditions is yet to be clarified as more recent data prove no statistically significant association between prevalence of significant atherosclerosis in anomalous coronary arteries in comparison to normal coronary arteries. Here we present a case of inferior STEMI in the context of double RCA, in which one of the two component branches was accidentally found after an "unexpected" jump of the coronary guidewire to treat what was initially considered the main vessel.

Keywords: Double right coronary artery; Percutaneous coronary intervention; ST-segment elevation myocardial infarction.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Angioplasty, Balloon, Coronary* / instrumentation
  • Coronary Angiography
  • Coronary Occlusion / complications
  • Coronary Occlusion / diagnostic imaging
  • Coronary Occlusion / therapy*
  • Coronary Vessel Anomalies / complications*
  • Coronary Vessel Anomalies / diagnostic imaging
  • Drug-Eluting Stents
  • Female
  • Humans
  • Incidental Findings
  • Inferior Wall Myocardial Infarction / diagnostic imaging
  • Inferior Wall Myocardial Infarction / etiology
  • Inferior Wall Myocardial Infarction / therapy*
  • Middle Aged
  • ST Elevation Myocardial Infarction / diagnostic imaging
  • ST Elevation Myocardial Infarction / etiology
  • ST Elevation Myocardial Infarction / therapy*
  • Treatment Outcome