Successful treatment of acute myocardial infarction associated with anomalous origin of coronary artery

Bort D.V.; Rudenko A.V.; Kostogryz V.B.; Rakitskaya I.V.; Taradin G.G.

doi:https://doi.org/10.17116/kardio20261902192

Bort D.V.

Gusak Institute of Emergency and Reconstructive Surgery, Donetsk, Russia

ORCID: 0000-0003-4782-2071

Rudenko A.V.

Gorky Donetsk State Medical University, Donetsk, Russia

ORCID: 0009-0008-0867-7725

Kostogryz V.B.

Gusak Institute of Emergency and Reconstructive Surgery, Donetsk, Russia

ORCID: 0000-0003-4767-3678

Rakitskaya I.V.

Gorky Donetsk State Medical University, Donetsk, Russia

ORCID: 0000-0003-2694-6614

Taradin G.G.

Gorky Donetsk State Medical University, Donetsk, Russia

ORCID: 0000-0003-3984-8482

Successful treatment of acute myocardial infarction associated with anomalous origin of coronary artery

Authors:

Bort D.V., Rudenko A.V., Kostogryz V.B., Rakitskaya I.V., Taradin G.G.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2026;19(2): 92‑98

DOI: 10.17116/kardio20261902192

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To cite this article:

Bort DV, Rudenko AV, Kostogryz VB, Rakitskaya IV, Taradin GG. Successful treatment of acute myocardial infarction associated with anomalous origin of coronary artery. Russian Journal of Cardiology and Cardiovascular Surgery. 2026;19(2):92‑98. (In Russ.)
https://doi.org/10.17116/kardio20261902192

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

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Abstract:

The authors describe myocardial infarction in a 73-year-old patient. Urgent coronary angiography revealed a variant of anomalous origin of coronary artery (AOCA) (circumflex artery arising from the proximal part of the right coronary artery). Clinical, echocardiographic and angiographic data on acute myocardial infarction necessitated percutaneous coronary intervention with proximal right coronary artery stenting. Recovery period was uneventful with positive dynamics in clinical, electrocardiographic and laboratory parameters. The paper discusses the prevalence of coronary artery anomalies. The need for early detection of AOCA is emphasized because this anomaly may be associated with myocardial ischemia, cardiac arrhythmias and sudden cardiac death. The role of echocardiography in visualization of the so-called RAC-sign typical for retroaortic course of abnormally located CA is discussed separately. CT and coronary angiography are crucial for detecting AOCA.

Keywords:

anomalous origin of coronary artery

myocardial infarction

coronary angiography

RAC-sign

stenting

treatment

Authors:

Bort D.V.

Gusak Institute of Emergency and Reconstructive Surgery, Donetsk, Russia

ORCID: 0000-0003-4782-2071

Rudenko A.V.

Gorky Donetsk State Medical University, Donetsk, Russia

ORCID: 0009-0008-0867-7725

Kostogryz V.B.

Gusak Institute of Emergency and Reconstructive Surgery, Donetsk, Russia

ORCID: 0000-0003-4767-3678

Rakitskaya I.V.

Gorky Donetsk State Medical University, Donetsk, Russia

ORCID: 0000-0003-2694-6614

Taradin G.G.

Gorky Donetsk State Medical University, Donetsk, Russia

ORCID: 0000-0003-3984-8482

Received:

16.12.2025

Accepted:

27.01.2026

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References:

Angelini P, Velasco JA, Flamm S. Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation. 2002;105(20):2449-2454. https://doi.org/10.1161/01.cir.0000016175.49835.57
Pérez-Pomares JM, de la Pompa JL, Franco D et al. Congenital coronary artery anomalies: a bridge from embryology to anatomy and pathophysiology--a position statement of the development, anatomy, and pathology ESC Working Group. Cardiovasc Res. 2016;109(2):204-16. https://doi.org/10.1093/cvr/cvv251
Rizzo S, De Gaspari M, Frescura C et al. Sudden death and coronary artery anomalies. Front Cardiovasc Med. 2021;8:636589. https://doi.org/10.3389/fcvm.2021.636589
Bashyal K, Koirala B, Bhattarai A et al. Spectrum of coronary anomalies and their categorical approach: rare case series. J Surg Case Rep. 2022;2022(7):rjac310. https://doi.org/10.1093/jscr/rjac310
Angelini P. Coronary artery anomalies: an entity in search of an identity. Circulation. 2007;115(10):1296-1305. https://doi.org/10.1161/circulationaha.106.618082
Kim JH, Baggish AL, Levine BD et al. American Heart Association Leadership Committee of the Council on Clinical Cardiology; Council on Basic Cardiovascular Sciences; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; Council on Peripheral Vascular Disease; American College of Cardiology; Clinical considerations for competitive sports participation for athletes with cardiovascular abnormalities: a scientific statement from the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 2025;85(10):1059-1108. https://doi.org/10.1016/j.jacc.2024.12.025
Zeen Al-Deen A, Al-Hashimi H, Baaj B, Siyagha K, Roqia SA, Fatima T, Tabatabai S. Prevalence and patterns of congenital coronary artery anomalies in patients undergoing coronary angiography at a tertiary care hospital in the United Arab Emirates: A Retrospective Analysis. Cureus. 2025;17(7):e87576. https://doi.org/10.7759/cureus.87576
Hoover JA, Catakam K, Wittenberg RE, Bloom JP, Yeh DD, Han QJ, Stefanescu Schmidt AC. Coronary artery anomalies in review: anomalous origin, aneurysms, and fistulae. Methodist Debakey Cardiovasc J. 2025;21(4):54-64. https://doi.org/10.14797/mdcvj.1613
Jiang X, Zhou P, Wen C et al. Coronary anomalies in 11,267 southwest Chinese patients determined by angiography. Biomed Res Int. 2021;2021:6693784. https://doi.org/10.1155/2021/6693784
Angelini P, Cheong BY, Lenge De Rosen VV et al. High-risk cardiovascular conditions in sports-related sudden death: prevalence in 5,169 schoolchildren screened via cardiac magnetic resonance. Tex Heart Inst J. 2018;45(4):205-213. https://doi.org/10.14503/THIJ-18-6645
Braiteh N, Rehman W, Ali W, Ahmed O. An extremely rare presentation of four coronary anomaly patterns originating from the right coronary sinus. Case Rep Cardiol. 2022;2022:7125401. https://doi.org/10.1155/2022/7125401
Zheng RH, Wang AB, Zhao C, Zhang J, Han B, Zhu M. Anomalous origin of the right coronary artery with severe stenosis of the left coronary artery orifice: a case study. J Cardiothorac Surg. 2025;20(1):198. https://doi.org/10.1186/s13019-025-03414-w
Turner II, Turek JW, Jaggers J, Herlong JR, Lawson DS, Lodge AJ. Anomalous aortic origin of a coronary artery: preoperative diagnosis and surgical planning. World J Pediatr Congenit Heart Surg. 2011;2(3):340-345. https://doi.org/10.1177/2150135111406938
Li K, Hu P, Luo X et al. Anomalous origin of the coronary artery: prevalence and coronary artery disease in adults undergoing coronary tomographic angiography. BMC Cardiovasc Disord. 2024;24(1):271. https://doi.org/10.1186/s12872-024-03942-8
Kosulina VM, Bashnyak VS, Shirobokikh OE, Krupichka KS. Anomalous origin of the left coronary artery. RAC-sign. A case report. Cardiovascular Therapy and Prevention. 2024;23(8):4050. (In Russ.). https://doi.org/10.15829/1728-8800-2024-4050
Brothers JA, Frommelt MA, Jaquiss RDB, Myerburg RJ, Fraser CD Jr, Tweddell JS. Expert consensus guidelines: anomalous aortic origin of a coronary artery. J Thorac Cardiovasc Surg. 2017;153(6):1440-1457. https://doi.org/10.1016/j.jtcvs.2016.06.066
Sultanova OE, Chernysheva YeN, Nassif SH, Hadadi I, Bensatt A, Arakelov VK, Khasaeva TY, Dyatlova YuV. The effect of undifferentiated connective tissue dysplasia syndrome on the anatomy of coronary vessels in acute coronary syndrome. Disease Treatment and Prevention. 2025;15(2):29-33. (In Russ.).
Skaletsky KV, Namitokov AM, Donets EK, Kruchinova SV, Gagin VA, Kosmacheva ED. Echocardiographic phenomenon “RAC-sign” in the anomalous course of circumflex artery: a case report. Russian Journal of Cardiology. 2022;27(2S):4889. (In Russ.). https://doi.org/10.15829/1560-4071-2022-4889
Budaj-Fidecka A, Gumiezna K, Glowczynska R, Grabowski M. The incidence and significance of the RAC sign in transthoracic echocardiography in the population of a tertiary hospital outpatient cardiology clinic. Eur Heart J Cardiovasc Imaging. 2025;26 (Suppl. 1). https://doi.org/10.1093/ehjci/jeae333.390
Witt CM, Elvert LA, Konik EA et al. The RAC Sign: retroaortic anomalous coronary artery visualization by transthoracic echocardiography. JACC Cardiovasc Imaging. 2018;11(4):648-649. https://doi.org/10.1016/j.jcmg.2017.06.011
Nasis A, Machado C, Cameron JD, Troupis JM, Meredith IT, Seneviratne SK. Anatomic characteristics and outcome of adults with coronary arteries arising from an anomalous location detected with coronary computed tomography angiography. Int J Cardiovasc Imaging. 2015;31(1):181-91. https://doi.org/10.1007/s10554-014-0535-4