Anomalous aortic origin of a coronary artery (AAOCA) from the opposite sinus of Valsalva

Description 

A 77-year-old woman with multiple risk factors for coronary artery disease, was referred for left heart catheterisation after abnormal dobutamine stress test, revealing anterior and anterolateral hypokineses. Coronary angiogram revealed a large, dominant right coronary artery (figure 1A), originating from the right coronary cusp along with underdeveloped anomalous left coronary system. Left main artery was absent. Left anterior descending artery (LAD) was originating from right coronary cusp posteriorly (figure 1B), while the left circumflex artery (LCx) from the same cusp anteriorly (figure 1C). Probably the small calibre of the LAD and LCx might be the cause of abnormal stress echo findings. No significant obstructive disease was noted and the patient was qualified for medical treatment. Subsequent CT of the heart confirmed the anomalous coronary anatomy (figure 2).

Figure 1

(A) LAO cranial view. Dominant large calibre right...

https://ift.tt/2wRjEYF