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Interarterial course of left coronary artery

Case contributed by: Dr Jens Christian Fischer

Presentation:

60 year old man presenting with typical chest pain and an STEMI.

Patient Data:

Age: 60
Gender: Male
From the case: Interarterial course of left coronary artery
Modality: CT

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  • <p>Atypical origin and course of the left coronary artery</p> Common origin of right and left coronary artery out of the right coronary sinus with interarterial course of the LCA. Other findings are coronary arteriosclerosis an a stentgraft in the middle segment of the RCA.

C+ arterial phase

Atypical origin and course of the left coronary artery

Common origin of right and left coronary artery out of the right coronary sinus with interarterial course of the LCA. Other findings are coronary arteriosclerosis an a stentgraft in the middle segment of the RCA.

Case Discussion:

Patient with STEMI due to a occlusion of the middle segment of the right coronary artery. As another finding, conventional angiography showed common ostium of both coronary arteries at the right coronary sinus and a "malignant" course has been suspected.

The prospective ECG-triggered CTA of the coronaries shows the common origin out of the right coronary sinus and the so called interarterial course of the LCA between the aortic root and the pulmonary trunk.

This anomaly is called a "malignant" course because it is associated with a higher risk of caridac ischemia and sudden cardiac death.

Coronary bypass surgery is planned.

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