COVID-19-induced myocarditis in patient with anomalous origin of the left circumflex artery from the right coronary artery: a case report

• Published in: Jornal vascular brasileiro 2022-01, Vol.21, p.e20210213
• Main Authors: Khalil, Majed, Danash, Batoul, Akiki, Dany, Khoury, Nabil
• Format: Article
• Language: English
• Subjects: anomalous circumflex artery; CARDIAC & CARDIOVASCULAR SYSTEMS; Case Report; coronary angiography; COVID-19; PERIPHERAL VASCULAR DISEASE; right coronary artery; SURGERY; viral-induced myocarditis
• ISSN: 1677-5449; 1677-7301; 1677-7301
• DOI: 10.1590/1677-5449.202102132

The prevalence of coronary artery anomalies has been increasing due to the increasing usage of coronary angiography. There is a paucity of literature concerning management of viral-induced myocarditis in patients with anomalous coronary artery. We present a very unusual case of a 44-year-old man with anomalous origin of the left circumflex artery from the proximal ostium of the right coronary artery who was admitted for COVID-19-induced myocarditis. He presented with signs of heart failure and coronary angiography revealed the left circumflex artery with a separate ostium originating from the proximal right coronary artery. He was treated medically with Bisoprolol, Perindopril Arginine, Rivaroxaban, and Furosemide. His condition improved rapidly and he resumed regular life within 1 month. Coexistence of cardiac disease such as viral-induced myocarditis with an underlying anomalous origin of the coronary artery is challenging to spot and can lead to worse outcomes in case of misdiagnosis and inaccurate management.