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CASE REPORT
Year : 2019  |  Volume : 29  |  Issue : 2  |  Page : 65-67

Anomalous right coronary artery origin from left main stem: Role of cardio-computed tomography in the diagnosis and therapeutic Approach


1 Department of Radiology, University of Foggia, Foggia, Italy
2 Department of Cardiology, University of Foggia, Foggia, Italy
3 Cardiology Department, GVM Care and Research, Santa Maria Hospital, Bari, Italy

Correspondence Address:
Natale Daniele Brunetti
Department of Cardiology, University of Foggia, Foggia
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcecho.jcecho_49_18

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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.


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