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    Abstract Submision Fo Wecoc 2023

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    Egi Dwi Satria
    This case report describes an elderly man who presented with chest pain and was found to have an anteroseptal ST elevation myocardial infarction (STEMI). Coronary angiography revealed a total occlusion in the mid left anterior descending artery and an anomalous origin of the right coronary artery arising from the left coronary sinus. The patient underwent successful primary percutaneous coronary intervention with drug-eluting stent placement in the left anterior descending artery. Echocardiography following the procedure showed anteroseptal wall motion abnormalities. The report discusses the incidental finding of coronary artery anomalies in patients presenting with ischemic heart disease.

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    Abstract Submision Fo Wecoc 2023

    Uploaded by

    Egi Dwi Satria
    35 views2 pages
    This case report describes an elderly man who presented with chest pain and was found to have an anteroseptal ST elevation myocardial infarction (STEMI). Coronary angiography revealed a total occlusion in the mid left anterior descending artery and an anomalous origin of the right coronary artery arising from the left coronary sinus. The patient underwent successful primary percutaneous coronary intervention with drug-eluting stent placement in the left anterior descending artery. Echocardiography following the procedure showed anteroseptal wall motion abnormalities. The report discusses the incidental finding of coronary artery anomalies in patients presenting with ischemic heart disease.

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    This case report describes an elderly man who presented with chest pain and was found to have an anteroseptal ST elevation myocardial infarction (STEMI). Coronary angiography revealed a total occlusion in the mid left anterior descending artery and an anomalous origin of the right coronary artery arising from the left coronary sinus. The patient underwent successful primary percutaneous coronary intervention with drug-eluting stent placement in the left anterior descending artery. Echocardiography following the procedure showed anteroseptal wall motion abnormalities. The report discusses the incidental finding of coronary artery anomalies in patients presenting with ischemic heart disease.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    35 views2 pages

    Abstract Submision Fo Wecoc 2023

    Uploaded by

    Egi Dwi Satria
    This case report describes an elderly man who presented with chest pain and was found to have an anteroseptal ST elevation myocardial infarction (STEMI). Coronary angiography revealed a total occlusion in the mid left anterior descending artery and an anomalous origin of the right coronary artery arising from the left coronary sinus. The patient underwent successful primary percutaneous coronary intervention with drug-eluting stent placement in the left anterior descending artery. Echocardiography following the procedure showed anteroseptal wall motion abnormalities. The report discusses the incidental finding of coronary artery anomalies in patients presenting with ischemic heart disease.

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    © All Rights Reserved
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    of 2

    Case Report : Acute Myocardial Infarction in Elderly Patient with

    Suspected Coronary Artery Anomaly


    Egi Dwi Satria1,Asep Sopandiana A S2
    1
    General Practitioner Banjar Regional Hospital West Java. 2Interventional Cardiologist Banjar Regional Hospital
    West Java

    ABSTRACT
    Introduction
    Acute myocardial infarction with ST segment elevation (STEMI) is a life threathening
    condition that must be given immediate treatment. Reperfusion with Percutaneous Coronary
    Intervention (PCI) in culprit lesion of coronary artery occlusion is the definitive strategy in
    the management of STEMI patients. Normally, there are three main epicardial coronary
    arteries : the right coronary artery, emerging from the right sinus of valsava, and the left
    anterior descending and left circumflex coronary arteries, characterized by an initial common
    tract (the left main coronary artery) that arises from the left of sinus of valsava. In this case
    report, we found an unique case, elderly patient with anteroseptal STEMI with anomalous
    aortic origin of the coronaries, subvariant origin of right coronary artery from left aortic of
    sinus valsava.
    Case Illustration
    A 63 year old man come to emergency department with main complaint typical chest pain
    since one hour before admission. The patient never felt the same complaint before, and he
    was a heavy smoker and have history of hypertension, had no history of diabetes mellitus and
    previous history of heart disease. He was stable and remain alert, afebrile, BP :110/60 mmHg,
    HR 68 BPM, and physical examination was within normal limit. Laboratory blood
    examination shows normal values of cardiac enzyme (CKMB) on first examination, and
    increased up to about 10-fold on the second examination, other laboratory examination are
    within normal limit. ECG examination shows hyperacute T waves anteroseptal leads. The
    patient received initial management of acute myocardial infarction in emergency department,
    and was immediately referred to the cardiac catheterization laboratory for primary PCI
    strategy. In the coronary angiography procedur of primary PCI, a coronary artery anomaly
    was found with the right coronary artery arise frome left aortic of sinus valsava. Primary PCI
    with drug eluting stent (DES) was success performed on total occlusion in mid of left
    anterior descending artery (LAD), and contrast injection shows flow TIMI 3. After the
    procedure, the patient is transferred to high care unit for observation and care. The following
    day, transthoracal echocardiography was performed and shows anteroseptal regional wall
    motion abnormality with 50% of LVEF. And then the patient was discharged from hospital
    without any complaint and receive dual anti platelete theraphy, and statin.
    Conclusion
    Coronary artery anomaly (CAAs) are often discovered as an incidental finding during the
    diagnostic workup for ischemic heart disease. In line with the case An elderly man has an
    anteroseptal STEMI with coronary angiography shows a culprit lesion in mid of LAD, and
    had anomaly of RCA origin from the left aortic sinus. The case is interesting, because the
    clinical correlates and prognostic implication of CAAs remain poorly understood in this
    context, the guidline-recommended therapeutic choices are supported by a low level of
    scientific-evidence.
    Keywords: Acute Myocardial Infarction, STEMI, Coronary Artery Anomaly, CAAs

    Fig.1 12 Leads ECG shows Hyperacute T waves of Anteroseptal segments

    Fig.2 Total occlusion mid of LAD with anomalous origin of RCA

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