Primary Percutaneous Coronary Intervention in a Patient with Acute Inferior Myocardial Infarction and Agenesis of Right Coronary Artery. "In Search of a Coronary Ostium".

Coronary arteries with anomalous origin from the aorta may represent a trouble for interventional cardiologist, in particular in setting of acute coronary syndromes. Research of coronary ostium may cause crucial delay in reperfusion with important consequences for myocardial salvage. We described a case of inferior ST-elevation myocardial infarction (STEMI) complicated by bradyarrythmia and hypotension, and treated with primary percutaneous coronary intervention (PCI) in a patient with agenesis of right coronary ostium. The patient had only a single left coronary artery occluded at the distal portion before a bifurcation with a huge branch that encompassed the theoretical territories of right coronary artery.