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- W2042003706 abstract "A 40 year-old man with no coronary risk factors was admitted for evaluation of recent onset chest pain. The pain was intermittent and unrelated to exercise. Physical examination was unremarkable. Resting ECG and laboratory studies, including cardiac enzymes and D-dimer, were within normal limits. Transthoracic echocardiography showed normal left ventricular dimensions and 70% ejection fraction. Exercise electrocardiogram was inconclusive and non-invasive coronary angiography was performed using 64-slice multidetector computed tomography (MDCT). MDCT demonstrated no significant coronary atherosclerosis, but revealed the presence of a single coronary artery originating from the left sinus of the valsalva. The ostium of the right coronary artery could not be found in its usual location. Right coronary artery arose as a continuation of the distal left circumflex coronary artery (Fig. 1, Panel A). The left circumflex artery was largely dominant, giving off the obtuse marginal and 2 posterior descending arteries that coursed to the inferior interventricular sulcus. Thereafter the circumflex continued along the atrioventricular groove and coursed up toward the right sinus of the valsalva, giving rise to the right ventricular branches, in the same distribution as a normal right coronary artery. Maximum intensity projections (Fig. 1, Panel B) and the curved multiplanar reformatted images (Fig. 1, Panel C) delineated the course of the anomalous coronary better. The volume rendering images (Fig. 1, Panels D to I) improved the three-dimensional comprehension of the coronary anomaly, and the relationship with the surrounding anatomical structures. While unusual in its course, the patient's single coronary artery did not appear to be compromised either by coronary atherosclerosis or by a malignant proximal course between the great vessels. Therefore, it was not felt that the patient's chest pain was cardiac in origin. Therefore, the patient was managed conservatively and he was doing well after 12 months." @default.
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- W2042003706 date "2014-07-01" @default.
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- W2042003706 title "Single left coronary artery with the right coronary artery arising as a continuation from the distal circumflex coronary artery assessed by multislice computed tomography" @default.
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- W2042003706 doi "https://doi.org/10.1016/j.ijcard.2014.04.145" @default.
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