Presentation
Chest pain and tachycardia
Patient Data
CT coronary angiography
The right coronary artery arises from the left coronary cusp, passing at an acute angle to the right between the pulmonary trunk and ascending aorta, suggestive of the malignant origin of the right coronary artery. This is causing mild proximal vessel narrowing by extrinsic compression.
The total calcium score is zero.
Case Discussion
Due to the aberrant origin of the right coronary artery from the left coronary sinus, the origin is slit-like and the proximal vessel is narrowed due to extrinsic compression between the ascending aorta and pulmonary trunk. During physical activity, the artery may be compressed, and the flow within it may be compromised which can lead to myocardial ischemia in the right coronary artery territory. It carries a high risk of sudden cardiac death.
Co-author:- Dr. Ranjan Kumar, DMRD,FRCR.