Open AccessAnomalous right coronary artery origin from left main stem: Role of cardio-computed tomography in the diagnosis and therapeutic Approach
Author(s) -
Matteo Gravina,
Grazia Casavecchia,
Alessandro Martone,
Mario Sollitto,
Stefano Zicchino,
Andrea Cuculo,
Luca Macarini,
Matteo Di Biase,
Natale Daniele Brunetti
Publication year - 2019
Publication title -
journal of cardiovascular echography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.255
H-Index - 8
eISSN - 2347-193X
pISSN - 2211-4122
DOI - 10.4103/jcecho.jcecho_49_18
Subject(s) - medicine , cardiology , right coronary artery , left coronary artery , chest pain , radiology , artery , troponin , stenosis , coronary angiography , myocardial infarction
Anomalous coronary arteries (ACAs) are rare but potentially life-threatening abnormalities of coronary circulation. Most of the variants are benign; however, some may lead to myocardial ischemia and/or sudden cardiac arrest. We report the case of a 75-year-old male complaining of exertion chest discomfort. Admission electrocardiogram on presentation showed sinus bradycardia with a slight elevation of ST-T in inferior leads. Troponin levels, however, were normal. Coronary angiography showed an anomalous right coronary artery (RCA) originating from the left main stem without significant stenosis. Cardio-CT confirmed the anomalous origin of the RCA from the left main stem and showed its anomalous course between the aorta and the pulmonary artery. The patient was deemed a candidate for surgery and transferred to a cardiac surgery center. Only the exact definition of the anatomic and clinical features of ACAs may allow the identification of the most appropriate and effective treatment. Multislice computed tomography may play a fundamental role in the diagnosis and treatment of ACAs.