Four Coronary Arteries Separately Originating from the Right Sinus of Valsalva

Tatsuya Hondo; Atsuo Mogami; Shunsuke Miyauchi; Sho Okamura; Takuo Sakura; Yoshiharu Sada; Keiji Matsuda; Shin Eno

doi:10.2169/internalmedicine.2992-19

CASE REPORTS

Four Coronary Arteries Separately Originating from the Right Sinus of Valsalva

Tatsuya Hondo, Atsuo Mogami, Shunsuke Miyauchi, Sho Okamura, Takuo Sakura, Yoshiharu Sada, Keiji Matsuda, Shin Eno

Author information

Tatsuya Hondo
Department of Cardiology, Chugoku Rosai Hospital, Japan Organization of Occupational Health and Safety, Japan
Atsuo Mogami
Department of Cardiology, Chugoku Rosai Hospital, Japan Organization of Occupational Health and Safety, Japan
Shunsuke Miyauchi
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
Sho Okamura
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
Takuo Sakura
Department of Cardiology, Chugoku Rosai Hospital, Japan Organization of Occupational Health and Safety, Japan
Yoshiharu Sada
Department of Cardiology, Chugoku Rosai Hospital, Japan Organization of Occupational Health and Safety, Japan
Keiji Matsuda
Department of Cardiology, Chugoku Rosai Hospital, Japan Organization of Occupational Health and Safety, Japan
Shin Eno
Department of Cardiology, Chugoku Rosai Hospital, Japan Organization of Occupational Health and Safety, Japan

Keywords: quadriostial origin, coronary artery disease, coronary artery anomalies, dual left anterior descending arteries, twin circumflex arteries

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 4 Pages 533-539

DOI https://doi.org/10.2169/internalmedicine.2992-19

Details

Abstract

An 82-year-old woman was admitted to our hospital with heart failure. Coronary angiography revealed one anatomically normal right coronary artery and three left coronary arteries (LCA-1, LSA-2, and LSA-3) separately originating from the right sinus of Valsalva, comprising multiple atherosclerotic lesions. LCA-1 became the obtuse marginal branch after branching off into the septal branches. LCA-2 was the main circumflex artery with an obstructive lesion. LCA-3 corresponded to the distal part of the anterior descending branch. The patient died 14 days after hospitalization. We describe the rarity of quadriostial origin, the unusual course, and the unusual branching of the coronary arteries.

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