[Anterior myocardial infarction associated with anomalous origin of the left main coronary artery].

Background: Coronary anomalies are those conditions characterized by the abnormal origin or course of the epicardial arteries. This generates challenges at the time of diagnosis by catheterization, which is why it is important that the cardiologist is related to these variations. The origin of the left coronary artery in the right sinus of Valsalva has a low incidence. It is reported the case of a patient with myocardial infarction who presented this anomaly with total thrombotic occlusion.

Clinical case: 69-year-old man who presented myocardial infarction with ST segment elevation in the anteroseptal region. The catheterization reported left coronary artery with anterior origin and the right coronary sinus. The anterior descending artery presented thrombotic occlusion, which is why a stent was placed successfully. Subsequently, the tomography of the coronary arteries confirmed the anomalous origin of the left coronary artery from the right sinus of Valsalva, with a lateral and anterior course to the right ventricle.

Conclusions: Patients with anomalous origin of the coronary arteries are exposed to greater events of ischemia and sudden death. However, some patients present with no previous history of acute coronary syndrome associated with thrombotic occlusion, which can represent a diagnostic challenge at the time of catheterization and coronary intervention due to the anatomic variability they may present.