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Usefulness of multidetector CT angiography for anomalous origin of coronary artery

Takenori Ishisone1, Mamoru Satoh1, Hitoshi Okabayashi1

  • 1Iwate Medical University School of Medicine, Morioka, Japan.

BMJ Case Reports
|August 24, 2014
PubMed

Insights

This study highlights a rare coronary artery anomaly causing exercise-induced syncope in a teen. Multidetector CT coronary angiography diagnosed the condition, which was successfully treated with surgery.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Exercise-induced syncope can have various causes, including cardiac conditions.
  • Congenital coronary artery anomalies are a potential, though often overlooked, cause of syncope.

Observation:

  • A 17-year-old male presented with exercise-induced syncope.
  • Standard exercise stress tests and ECGs were inconclusive.
  • Multidetector CT (MDCT) coronary angiography revealed an anomalous origin of the left coronary artery from the right coronary sinus.

Findings:

  • The patient's syncope was attributed to cardiogenic causes, specifically transient left main coronary artery stenosis.
  • The stenosis likely occurred due to the coronary artery being compressed between the aortic root and pulmonary trunk during exercise.
  • Patch coronary angioplasty successfully resolved the patient's symptoms.

Implications:

  • Clinicians should consider coronary artery anomalies in patients with unexplained exercise-induced syncope.
  • MDCT coronary angiography is a valuable non-invasive tool for diagnosing these anomalies.
  • Surgical correction of congenital coronary artery anomalies can effectively treat associated syncope.

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