Interarterial course of left coronary artery

Case contributed by Dr Jens Christian Fischer


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

Patient Data

Age: 60 years
Gender: Male

Atypical origin and course of the left coronary artery

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

Volume rendering - the pulmonary trunk has been removed to show the course and the origin of the LCA

Case Discussion

Patient with STEMI due to an 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 cardiac ischemia and sudden cardiac death.

Coronary bypass surgery is planned.

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Case information

rID: 12891
Published: 29th Jan 2011
Last edited: 14th Apr 2019
System: Cardiac
Inclusion in quiz mode: Included

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