Acute myocardial infarction during a dobutamine stress echocardiography, in a patient with angiographically normal coronaries.

We report a case of acute myocardial infarction during a dobutamine stress echo (DSE) study in a middle age man. Our patient experienced a severe crushing retrosternal pain at peak DSE study, at the time the ECG recorded an episode of non-sustained ventricular tachycardia followed by a persistent significant ST segment elevation in V2-V6 leads. Symptoms and ECG findings remained despite the use of intravenous (IV) nitrates and therefore thrombolysis was given.

Anomalous origin of right coronary artery from the mid-left anterior descending artery.

We report a case of a right coronary artery (RCA) originating from the mid-left anterior descending artery (LAD) coursing around and in front of the pulmonary artery. The anomaly was discovered incidentally during cardiac catheterization. It is only the second case of such an anomaly ever described.