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Association of myocardial infarction with malignant right coronary anomaly and coarctation of aorta (mid aortic syndrome)

Journal of Cardiology & Current Research
Ashish K Mohapatra MD, Ravinder S Sambi MD, Cyril James MD

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A young woman presenting to the Emergency Department with anginal symptoms and early repolarisation changes without specific ST-elevation or depression on electrocardiogram. Serology revealed elevated cardiac enzymes thus leading to the diagnosis of an acute myocardial infarction. Coronary angiography revealed a disease free left main coronary artery with inability to identify the right coronary artery ostium. The Aortography and Cardiac Computer Tomography (cardiac CT) demonstrated the right coronary artery originating from the left coronary sinus ventral to left main origin, lying between aorta and pulmonary trunk. At the age of 12 years, the patient underwent the resection of the stenotic inter-mesenterial aortic segment, implantation of (PTFE) Polytetrafluoroethylene Prosthesis with bilateral Implantation of renal arteries for coarctation of abdominal aorta with bilateral renal artery stenosis. The association of coarctation of aorta and right coronary artery anomaly with myocardial infarct is a very critical life-threatening situation, so that early diagnosis and prompt intervention is warranted


Myocardial Infarction, Anomalous Right Coronary Artery, Coarctation of Aorta, Mid-aortic-syndrome