Abstract
BACKGROUND: Coronary artery anomalies represent morphological deviations from standard coronary anatomy, occurring in less than 1% of the general population. Although coronary artery anomalies are often asymptomatic, they can lead to serious complications, including sudden cardiac death and cardiac ischemia. Percutaneous coronary intervention in patients with coronary artery anomalies presents challenges, with an increased risk of ostial dissection, particularly in the setting of ST-segment elevation myocardial infarction. CASE PRESENTATION: This case report describes the successful management of a 51-year-old Syrian male with inferior ST-segment elevation myocardial infarction caused by an anomalous aortic origin of a coronary artery arising from the ascending aorta. Following successful percutaneous coronary intervention, the patient achieved clinical stability. CONCLUSION: This case demonstrates the challenges and successful management of inferior ST-segment elevation myocardial infarction caused by anomalous aortic origin of a coronary artery. The case emphasizes the importance of recognizing and managing this rare condition, particularly during acute coronary syndromes. Further research is essential to optimize management strategies for patients with coronary artery anomalies, given the increased procedural risk of percutaneous coronary intervention.