Double Right Coronary Artery Arising From Separate Ostia

Abstract

We present a rare case of double right coronary artery (RCA) arising from separate ostia. A 62 years old male patient was admitted with acute onset retrosternal chest pain. ECG was suggestive of sinus rhythm with intraventicular conduction delay and pathological q waves in D3 and avF derivations without any significant ST segment elevations. In the coronary angiography, we detected double RCA, each had its own ostium arising separately from right aortic sinus with complete occlusion seen in one RCA. Plaques were present in left coronary arterial system. Guidewires could not be passed in the completely occluded right RCA and conservative therapy was recommended. Double RCA is a congenital coronary anomaly with a potential of atherosclerotic coronary artery disease which needs regular monitoring.

Angiographic study of double right coronary artery in Basra

“…The double right coronary artery usually diagnosed by conventional coronary angiography or multi-detector computed tomography. In our study the incidence of double right coronary artery was 3.3% and that disagreed with Ermis et al .,2014 ; Kunimasa et al, 2007;Erbagci et al, 2006 who found 0.01% , 0.07% and 0.01% respectively [17,11,18] but our result nearly corresponded to Angelini et al,1999 who recognized 1.23%. [19] Also the incidence increased in patients who lived in rural area and there is no similar study related to this issue but this differences in the incidence may related to geographical and genetic bases [20] or due to physicians in the other countries define this topic as high take off large ventricular artery from right coronary artery .…”