case_images: PMC5534290_01
case_images: Admission electrocardiogram.
case_images: CRIC2017-3972830.001.jpg
case_images: PMC5534290_01_CRIC2017-3972830.001.jpg
case_images: fig1
case_images: His first electrocardiogram (Figure 1) showed ectopic atrial rhythm, inferior inactive zone, and ST elevation in precordial leads V1-V3 (there were no previous electrocardiogram tracings available for comparison).
case_images: Coronary angiography. (a) Normal left coronary artery; (b) proximal occlusion of anomalous right coronary artery (black arrow) originating in the left Valsalva sinus.
case_images: CRIC2017-3972830.002.jpg
case_images: PMC5534290_01_CRIC2017-3972830.002.jpg
case_images: fig2
case_images: Left main and circumflex were free of significant obstruction and left anterior descending artery had a moderate systolic dynamic compression caused by intramyocardial bridging in the mid segment with normal TIMI flow (Figure 2).
case_images: Post-PCI angiogram. RCA seen in both LAO (a) and RAO (b) views. Good poststenting result in proximal RCA (TIMI 3) but slow flow (TIMI 2) in RV marginal branches. RCA: right coronary artery; LAO: left anterior oblique; RAO: right anterior oblique; TIMI: thrombolysis in myocardial infarction; RV: right ventricular.
case_images: CRIC2017-3972830.003.jpg
case_images: PMC5534290_01_CRIC2017-3972830.003.jpg
case_images: fig3
case_images: Right coronary artery had its anomalous origin close to the left coronary sinus and was occluded in the proximal segment (Figure 3).
case_images: Predischarge electrocardiogram.
case_images: CRIC2017-3972830.004.jpg
case_images: PMC5534290_01_CRIC2017-3972830.004.jpg
case_images: fig4
case_images: The patient had in-hospital course free of complications and predischarge evaluation revealed normal left and right ventricular function (ejection fraction 59%) and complete resolution of precordial electrocardiogram abnormalities and return to normal sinus rhythm (Figure 4).