Document Type

Article

Publication Title

Cureus

Abstract

A 75-year-old male, with a history of hypertension and peripheral vascular disease, presented to the cardiac catheterization lab for an elective coronary angiogram after an abnormal cardiac stress test. The coronary angiogram results showed a total of four separate coronary artery ostia. Within the right coronary cusp, there were two separate ostia as opposed to a single ostia that supplies the right coronary artery (RCA). The additional ostia gave rise to the left anterior descending artery (LAD). Further, as opposed to the single ostia in the left coronary cusp, there were two separate ostia creating a left circumflex (LCX) and marginal artery. Despite this anomalous anatomy, the patient was asymptomatic and instructed to continue to follow up with outpatient cardiology. Our case report discusses this unique quadriostial coronary anatomy, the complications that can arise from anomalous coronary arteries, diagnoses, and management of such cases.

DOI

10.7759/cureus.80653

Publication Date

3-16-2025

Keywords

anomalous left circumflex artery, cath lab, coronary artery anomaly (caa), first obtuse marginal branch of the left circumflex artery, four coronary ostia, left anterior descending artery (lad), left heart catheterization, right coronary artery (rca), sudden cardiac death (scd)

ISSN

2168-8184

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