Stress test to STEMI: Utility of coronary CTA in the diagnosis and management of anomalous right coronary artery from the left coronary cusp.
Anshuman DasAjay JosephNeeraj JollyDinesh K KalraPublished in: Echocardiography (Mount Kisco, N.Y.) (2018)
A 42-year-old woman presented to the emergency department with chest pain. Acute coronary syndrome was ruled out. During dobutamine stress echocardiography (DSE), she developed chest pain and inferior ST elevation. Emergent coronary angiography revealed no culprit lesions but did show an anomalous right coronary artery (RCA). Coronary CT angiography (CCTA) confirmed an anomalous RCA arising from the left coronary cusp with a slit-like ostium and interarterial course (ARCA-LCC-IA). Herein, we review the extant literature on ARCA-LCC-IA, its clinical presentation, the vital role of CTA and MRI in its diagnosis, as well as challenges and controversies surrounding management.
Keyphrases
- coronary artery
- pulmonary artery
- emergency department
- acute coronary syndrome
- coronary artery disease
- percutaneous coronary intervention
- systematic review
- magnetic resonance imaging
- computed tomography
- heart failure
- pulmonary hypertension
- single cell
- contrast enhanced
- antiplatelet therapy
- pulmonary arterial hypertension
- transcatheter aortic valve replacement