Origine anomala della coronaria sinistra dal seno di valsalsa destro: Osservazioni su un caso clinico

The anomalous origin of the left coronary artery is an extremely rare congenital anomaly. It may take one of two main forms: it may originate from the pulmonary trunk or, as in the case reported here, from the right aortic sinus. The latter form is very rarely found, as is shown by the literature. The anomaly in question is often the cause of cardiac arrest in young subjects, above all while carrying out physical exercise. Angina, even while resting, and the electrocardiographic alteration of the ST tract are the main characteristics of this pathology. Episodes of low flow ischemia are reported in the literature, correlated with the anomalous intramyocardial course of this coronary artery. The patient in question, who presented a history of hypertension, that was poorly controlled by drugs, and dyslipidemia, underwent myocardial revascularisation surgery following acute myocardial infarction and unsuccessful coronary angioplasty. These events were not triggered by the anomalous course of the artery, but by the presence of arteriosclerosis.