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Double Right Coronary Artery Originating from Separate Ostia: A Report of Two Cases.

Natarajan M, Kumarguru BN, Biligi DS, Raghupathi AR - N Am J Med Sci (2015)

Bottom Line: We report two cases of double RCA incidentally found in electrocuted patients.Both cases showed double RCA arising from separate ostia.It is important to know the anatomic variants.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.

ABSTRACT

Context: Coronary artery anomalies are uncommon and most are incidental findings. Double right coronary artery (RCA) is a very rare coronary artery anomaly.

Case report: We report two cases of double RCA incidentally found in electrocuted patients. Both cases showed double RCA arising from separate ostia. On microscopy, both right coronaries showed no significant pathology in the first case while in the second case, the posterior RCA showed features of obliterative arteritis.

Conclusion: Although double coronary artery has been regarded as hemodynamically insignificant, it may be associated with atherosclerosis, acute coronary syndromes, and other anomalies. It is important to know the anatomic variants. Meticulous grossing and careful observation could unearth hidden anomalies.

No MeSH data available.


Related in: MedlinePlus

Gross photograph of the heart showing double RCA arising from separate ostia (arrow) in Case 1
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Figure 1: Gross photograph of the heart showing double RCA arising from separate ostia (arrow) in Case 1

Mentions: The heart was grossed by the inflow and outflow method along the course of blood flow. The external surface showed soldier's plaques over the right lateral border. The weight and measurement values of the heart are depicted in Table 1. The pulmonary arterial trunk and the valves were normal. However, on dissecting the aorta, right coronary ostia were two in number [Figure 1] and left coronary ostia was only one in number. The ostia and course of the two coronary arteries were traced. Anterior RCA arising from one of the ostia coursed anteriorly. Anterior RCA coursed anteriorly descending downward, directed toward the apex. Posterior RCA from the other ostia coursed toward the junction between the right atrium and the right ventricle. The aorta also showed numerous foci of atheromatous plaque up to 0.5 cm from the root of the aorta. All the arteries appeared patent. Microscopy showed foci of neutrophil aggregates in the anterior wall of the left ventricle. The aorta showed features of atherosclerosis. However, sections from both the RCAs, left coronary artery, left anterior descending artery, and left circumflex artery revealed no significant pathology.


Double Right Coronary Artery Originating from Separate Ostia: A Report of Two Cases.

Natarajan M, Kumarguru BN, Biligi DS, Raghupathi AR - N Am J Med Sci (2015)

Gross photograph of the heart showing double RCA arising from separate ostia (arrow) in Case 1
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4561444&req=5

Figure 1: Gross photograph of the heart showing double RCA arising from separate ostia (arrow) in Case 1
Mentions: The heart was grossed by the inflow and outflow method along the course of blood flow. The external surface showed soldier's plaques over the right lateral border. The weight and measurement values of the heart are depicted in Table 1. The pulmonary arterial trunk and the valves were normal. However, on dissecting the aorta, right coronary ostia were two in number [Figure 1] and left coronary ostia was only one in number. The ostia and course of the two coronary arteries were traced. Anterior RCA arising from one of the ostia coursed anteriorly. Anterior RCA coursed anteriorly descending downward, directed toward the apex. Posterior RCA from the other ostia coursed toward the junction between the right atrium and the right ventricle. The aorta also showed numerous foci of atheromatous plaque up to 0.5 cm from the root of the aorta. All the arteries appeared patent. Microscopy showed foci of neutrophil aggregates in the anterior wall of the left ventricle. The aorta showed features of atherosclerosis. However, sections from both the RCAs, left coronary artery, left anterior descending artery, and left circumflex artery revealed no significant pathology.

Bottom Line: We report two cases of double RCA incidentally found in electrocuted patients.Both cases showed double RCA arising from separate ostia.It is important to know the anatomic variants.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.

ABSTRACT

Context: Coronary artery anomalies are uncommon and most are incidental findings. Double right coronary artery (RCA) is a very rare coronary artery anomaly.

Case report: We report two cases of double RCA incidentally found in electrocuted patients. Both cases showed double RCA arising from separate ostia. On microscopy, both right coronaries showed no significant pathology in the first case while in the second case, the posterior RCA showed features of obliterative arteritis.

Conclusion: Although double coronary artery has been regarded as hemodynamically insignificant, it may be associated with atherosclerosis, acute coronary syndromes, and other anomalies. It is important to know the anatomic variants. Meticulous grossing and careful observation could unearth hidden anomalies.

No MeSH data available.


Related in: MedlinePlus