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Ana Raquel Barbosa, Nuno Dias Ferreira, Olga Sousa, Pedro Braga, Anomalous coronary artery mimicking arrhythmogenic right ventricular cardiomyopathy, European Heart Journal - Cardiovascular Imaging, Volume 21, Issue 4, April 2020, Page 464, https://doi.org/10.1093/ehjci/jez269
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Extract
A 55-year-old man with no previous medical history presented with chest discomfort and palpitations with 5-h duration. He had been a high-competition rower and maintained an intense level of regular exercise. There was no family history of heart disease or sudden death.
The admission electrocardiogram showed a regular wide complex tachycardia with left bundle branch morphology and superior axis (Panel A). The patient became hypotensive and was electrically cardioverted. The electrocardiogram post-cardioversion was normal (Panel B). Troponin levels didn’t significantly increase. An echocardiogram revealed normal left ventricular function and a dilated right ventricle, with free-wall hypokinesis and depressed systolic function (Panel C). Arrhythmogenic right ventricular (RV) cardiomyopathy was considered the most likely diagnosis.
To exclude coronary artery disease a computed tomography angiography was done which showed the right coronary artery originating from the left coronary sinus and running between the aorta and the pulmonary trunk; significant luminal stenosis was seen at the origin (Panels D and E, arrow).