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Stress test to STEMI : Utility of coronary CTA in the diagnosis and management of anomalous right coronary artery from the left coronary cusp
Author(s) -
Das Anshuman,
Joseph Ajay,
Jolly Neeraj,
Kalra Dinesh K.
Publication year - 2017
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13700
Subject(s) - medicine , cardiology , chest pain , culprit , acute coronary syndrome , right coronary artery , coronary angiography , coronary anatomy , artery , radiology , myocardial infarction
A 42‐year‐old woman presented to the emergency department with chest pain. Acute coronary syndrome was ruled out. During dobutamine stress echocardiography ( DSE ), she developed chest pain and inferior ST elevation. Emergent coronary angiography revealed no culprit lesions but did show an anomalous right coronary artery ( RCA ). Coronary CT angiography ( CCTA ) confirmed an anomalous RCA arising from the left coronary cusp with a slit‐like ostium and interarterial course ( ARCA ‐ LCC ‐ IA ). Herein, we review the extant literature on ARCA ‐ LCC ‐ IA , its clinical presentation, the vital role of CTA and MRI in its diagnosis, as well as challenges and controversies surrounding management.