PMC8669105_01
Angiographic image of this patient. (A) (AP + CRA30 ) the left anterior descending branch. (B) (RAO30  + CAU20 ) the circumflex branch. (C) (AP + CRA20 ) the right coronary artery.
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F1
Biochemical examination showed "hypersensitive troponin I (TnI): 27.052 ng/ml (normal range: 0-0.78), myoglobin (MB): 4,102 ng/ml (normal range: 0-85), creatine kinase-MB (CK-MB): 297 U/L (normal range: 0-24)." Given the high probability of acute myocardial infarction, coronary angiography was immediately performed but showed no signs of blockage or stenosis in the left main, left anterior descending branch (Figure 1A), or left circumflex coronary artery (Figure 1B). However, the ostium of the right coronary artery was unable to be engaged with the angiographic catheter due to an abnormal origin between the non-coronary sinus and the left coronary sinus ("pigtail" catheter angiography, Figure 1C). After carefully reviewing the coronary angiography images, they found that the left coronary artery was the dominant feeding artery, and that the right coronary artery was able to be observed (Figure 1C).