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A case report of right coronary artery agenesis diagnosed by computed tomography coronary angiography

Ernesto Forte1, Bruna Punzo1, Marco Agrusta2

  • 1IRCCS SDN, Naples.

Medicine
|February 13, 2020
PubMed

Insights

Computed tomography coronary angiography (CTCA) diagnosed a rare single coronary artery anomaly in a woman with abnormal exercise tests. This imaging modality effectively differentiated congenital heart anomalies from coronary artery disease.

Area of Science:

  • Cardiovascular Imaging
  • Congenital Heart Disease
  • Coronary Artery Anomalies

Background:

  • Single coronary artery is a rare congenital anomaly where the entire heart is supplied by one coronary ostium.
  • Coronary artery anomalies can mimic or coexist with coronary artery disease (CAD).

Observation:

  • A 45-year-old woman presented with an altered exercise test, prompting evaluation for CAD.
  • Computed tomography coronary angiography (CTCA) revealed the absence of the right coronary artery (RCA).
  • The left anterior descending artery and left circumflex artery (LCX) had normal origins, with the LCX supplying the posterior interventricular and posterolateral arteries.

Findings:

  • CTCA confirmed a single coronary artery anomaly without immediately life-threatening features.
  • The anomaly was distinguished from significant coronary artery disease.
  • No surgical intervention was deemed necessary.

Implications:

  • CTCA is a crucial first-line imaging tool for evaluating ECG abnormalities.
  • It enables accurate differential diagnosis between CAD and congenital heart conditions.
  • Non-invasive imaging aids in management decisions for coronary anomalies.
Abstract

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