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Year : 2022  |  Volume : 8  |  Issue : 3  |  Page : 178-181

Left main coronary artery arising from the right coronary sinus presenting as acute coronary syndrome: A rare anomaly managed conservatively

1 Department of Medicine, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
2 Department of Cardiology, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India

Correspondence Address:
Saket Toshniwal
Department of Medicine, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpcs.jpcs_51_22

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Coronary artery anomalies are extremely rare with a prevalence of 2.33% and they are extremely difficult to diagnose with the help of conventional tests. Once diagnosed, the associated life-threatening risks and complications that arise during surgical management are the dangers related to such anomalies. We present a case of a 45–year-old female, with chief complaints of chest pain radiating to back and left shoulder associated with palpitations for 7 days, a known case of systemic hypertension and diabetes mellitus type 2 for 7 years on regular medications. A series of investigations were conducted that included an electrocardiogram showing ischemic changes, a two-dimensional echocardiography that revealed globally dysfunctional left ventricle and an ejection fraction of 45%, and finally, a diagnostic coronary angiography leading to the diagnosis of the an abnormal origin of the left main coronary artery through the right coronary sinus associated with 80% stenotic lesion in the “left anterior descending artery” and 90% stenotic lesion in the “left circumflex artery”. The report concludes that anomalies arising from coronary arteries are extremely infrequent and difficult to diagnose. In addition, they can present with life-threatening complications during surgical management.

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