Anomalous right coronary artery arising from the left coronary ostium seen on coronary catheter angiogram
Presentation
Follow up metastatic colon cancer.
Patient Data
The right coronary artery artery arises from the left coronary sinus and has an interarterial course between the aorta and the pulmonary artery. The left coronary artery aises normally. Left-sided SVC drains into the coronary sinus. Liver metatstases.
Left coronary artery catheterization shows anomalous small caliber right coronary artery arising from the left coronary sinus. Left dominant system. No flow limiting lesions.
Case Discussion
This patient had had multiple CT scans, but the anomalous right coronary artery origin was obscured in each instance but one by cardiac motion artifact on non-gated scans. Even on the CT scan shown, the anomaly is barely visible, but could be a source of ischemia given its interarterial course between the aorta and the pulmonary artery. The coronary catheter angiogram confirms the anomalous origin of the right coronary artey from the left coronary sinus. The interarterial course of the anomalous vessel is much easier to recognize on the CT than the catheter angiogram.
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