Chest pain for CTCA
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Origins: Normal Dominance: Left
Left Main Coronary Artery (LMCA): Normal.
Left Anterior Descending (LAD): Large amount of complete myocardial bridging of the mid segment. No obstructive disease evident. No diagonal branch identified.
Circumflex artery (Cx): Normal.
1st obtuse marginal branch (OM1), OM2, OM3 - Normal, and distal vessels not well visualised.
Right Coronary Artery (RCA): Small vessel, Normal.
Posterior descending artery (PDA) and Posterior left ventricular branch (PLV) - not well-visualized.
Dual lead pacemaker wires noted, causing moderately severe artefact. Enlarged left atrium. Minor aortic valvular calcification.
The LAD dives quiet deep into the myocardium. Myocardial bridging is often asymptomatic, however in this case it was presumed to be the cause of the symptoms due to both the absence of any CAD and the severity of bridging.