Anomalous RCA with benign course

Case contributed by Dr Craig Hacking

Presentation

Cardiac failure. AF. cardiomyopathy. Abnormal origin of RCA on catheter angiogram.

Patient Data

Age: 50
Gender: Male
Modality: CT

Coronary arteries

Origins: Anomalous LCA origin arising from a large common trunk from the right coronary sinus. The common trunk is large.

RCA is dominant.

The anomalous LCA courses anterior the RVOT before coursing posteriorly to give off the LAD, diagonal, circumflex and obtuse marginal branches.

LMCA - Noncalcific eccentric plaques, 25-49% stenoses, in the anomalous segment just anterior to the RVOT and immediately distal to the LAD.

LAD - small, patent. Anomalous LCA segment giving off at least 2 small patent diagonal branches has partially calcific plaque with probable moderate stenosis. Small diagonal branches are patent.

LCx - continuation terminating as OM branch is patent.

RCA - Large, with scattered partially calcific plaque with no significant stenosis.

PDA, PLV - Large, normal

Case Discussion

This benign course of the LMCA passes anterior to the RVOT and hence not at risk of compression between arterial structures (compared with the inter-arterial course of a malignant anomalous course of a coronary artery.)

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Case Information

rID: 34977
Diagnostic certainty: Certain
Case created: 18th Mar 2015
Last edited: 28th Aug 2015
System: Cardiac
Inclusion in quiz mode: Included

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