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Anomalous Origin of the Right Coronary Artery from the Left Coronary Sinus: High Interarterial Course of Right Coronary Artery

Author : D. A. Paramita, S. Suhendro, T. V. Yoshinta, E. Leonid
Upload Date : 19-04-2018

Background: Coronary artery anomalies are uncommon but potentially lethal with an incidence of about 1% in patients for coronary angiography. anomalous origin of coronary artery has significant clinical implications due to its association with myocardial ischemia, lethal arrhythmia and even sudden cardiac death. The development of electrocardiographically gated multidetector CT allows for the accurate and noninvasive depiction of coronary artery anomalies, and multidetector CT has been shown to be superior to conventional coronary angiography in delineating the origin and proximal path of anomalous coronary arteries.

 

Case discussion:  A 33 year old woman came to the outpatient clinics with chief complaint of near-syncope since 3 years ago. Patient felt near-syncope when she had more activities. Patient also reported that she became lost conciousness more often for three months. Futhermore, patient felt chest pain that increased with activity and relieved by rest. This syncope and chest pain also relieved by beta-blocker medication. She said that she has no risk factor or family history of coronary artery disease. On physical examination, patient had normal vital sign and normal cardiac examination. The CT scan found right coronary artery (RCA) originated from left coronary sinus and proximal RCA was located between aorta and pulmonary artery. Therefore patient was diagnosed with anomalous right coronary artery originates from the left coronary sinus (high interarterial course of the RCA).

Summary: Reported a rare case of a 33 year old woman came to the outpatient clinics with chief complaint of near-syncope since 3 years ago. Patient also felt syncope and chest pain more often in this three months. The diagnosis of anomalous right coronary artery originates from the left coronary sinus (high interarterial course of the RCA) was made by cardiac CT scan.

KEYWORDS : right coronary anomaly, high interarterial course of RCA, cardiac CT scan


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