© 2004 by BMJ Publishing Group & British Cardiac Society
Images in cardiology
An anomalous right coronary artery shown by multislice CT coronary angiography
D.R.Coles@bristol.ac.uk
Keywords: Images in cardiology
| The first 150 words of the full text of this article appear below. |
A 78 year old woman presented to hospital with chest pain and anterior T wave changes. She was started on clexane, intravenous (iv) nitrate, and iv tirofiban, and transferred for inpatient cardiac catheterisation. The proximal left anterior descending (LAD) coronary artery showed a subtotal lesion, however the right coronary artery (RCA) could not be cannulated by an experienced operator. The aortogram showed flow into a small atypical RCA, and the distal RCA was shown by collaterals from the LAD. In view of the development of a large groin haematoma and no recent chest pain, percutaneous coronary intervention to the LAD was deferred and a multislice computed tomography (MSCT) coronary angiogram was arranged to exclude an ostial RCA lesion.
MSCT coronary angiogram (Sensation 16, Siemens, Germany) was performed using an ECG gated standard protocol. An atypical RCA was demonstrated originating from the left sinus of Valsalva. It was small in overall
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