Anomalous left main coronary arterial origin

Case contributed by Dr Rajani Sharath

Presentation

Shortness of breath with anginal symptoms with positive TMT

Patient Data

Age: 55 yr
Gender: Male

Cardiac CT

Modality: CT

MDCT coronary angiography post processed images (MIP and VRT) showing RCA and LMCA arising from right coronary cusp with separate ostia with retro aortic course of long LMCA before trifurcating.

Case Discussion

An aberrant origin of left main  coronary artery from right coronary aortic sinus is a rare anomaly, found in 0.0024% to 0.02% of the population.

The course of the anomalous LMCA can be of 4 types

  • Interarterial
  • Prepulmonic
  • Retroaortic
  • Subpulmonic

Interarterial course that is between aorta and pulmonary artery is considered malignant and has been associated with ischemic events and sudden death.

MDCT can clearly depict origin and course of involved coronary noninvasively.

 

PlayAdd to Share

Case Information

rID: 26078
Diagnostic certainty: Certain
Case created: 28th Nov 2013
Last edited: 27th May 2016
Systems: Cardiac, Vascular
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.