CT - Coronary CT angiography
Left coronary system:
The left main coronary artery originates from the right anterior sinus with a course between the RVOT/main pulmonary artery and the aorta. The left main coronary artery is long and of medium diameter. The left anterior descending artery originates from the left main. This artery is medium in size and mildly calcified. This artery has one diagonal. The proximal left anterior descending coronary artery has a non-flow-limiting (<50%) stenosis. The mid-left anterior descending coronary artery has a non-flow-limiting (<50%) stenosis. The circumflex coronary artery originates from the left main coronary artery. This artery is medium in size and without calcification. This artery has three major obtuse marginals. The circumflex coronary artery is free of stenosis in its proximal, and distal segments.
Right coronary system:
The right coronary artery originates from the right anterior sinus. This artery is medium in size and without calcification. The proximal right coronary artery has severe (70-90%) stenosis. The distal right coronary artery has a non-flow-limiting (<50%) stenosis.
Opinion:
Right dominant system with anomalous origin of left main from the right coronary sinus, with a course between the right ventricular outflow tract/main pulmonary artery and aorta, severe stenosis of proximal RCA, non-obstructive disease of LAD, CAD RADS 4a/P2/E.