PMC4518180_01
Ventricular fibrillation as the initial rhythm at presentation.
CRIC2015-806291.001.jpg
PMC4518180_01_CRIC2015-806291.001.jpg
fig1
When emergency medical service found the patient at home, the presenting rhythm was ventricular fibrillation (Figure 1) and patient was shocked twice with reversal of spontaneous circulation in less than 4 minutes.
EKG showing sinus rhythm with right bundle branch block, left anterior fascicular block, and nonspecific ST-T wave changes.
CRIC2015-806291.002.jpg
PMC4518180_01_CRIC2015-806291.002.jpg
fig2
An electrocardiogram (EKG) showed sinus tachycardia, complete right bundle branch block (RBBB) with left anterior fascicular block (LAFB) and nonspecific ST-T wave changes (Figure 2).
Coronary angiogram showing clear coronaries and anomalous left anterior descending artery originating from the right coronary cusp. RCA: right coronary artery; LAD: left anterior descending artery; PL: posterolateral branch.
CRIC2015-806291.003.jpg
PMC4518180_01_CRIC2015-806291.003.jpg
fig3
Coronary angiogram (Figure 3) revealed nonobstructive epicardial coronaries with mildly elevated left ventricular end diastolic pressure (LVEDP) of 21 mmHg.
Cardiac coronary CAT scan demonstrating anomalous left coronary artery originating from the right coronary cusp and coursing between aorta and pulmonary artery followed by intramural course. LAD: left anterior descending artery; RCA: right coronary artery.
CRIC2015-806291.004.jpg
PMC4518180_01_CRIC2015-806291.004.jpg
fig4
Cardiac coronary CAT scan (Figure 4) was obtained that showed anomalous left anterior descending artery (LAD) originating from the right coronary sinus sharing a common ostium with the right coronary artery (RCA).