PMC3184710_01
(A) Coronary angiography, left anterior oblique view. CMS, common main stem; LMS, left main stem; LAD, left anterior descending artery; LCX, left circumflex; RCA, right coronary artery. (B) Same projection to the multi-slice CT scan (LightSpeed VCT 64-slice Scanner, GE Healthcare) showing a single coronary artery.
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F1
CK-MB was 7.2 ng/mL (<5 ng/mL), Troponin I was 0.62 ng/mL (<0.04 ng/mL) and, therefore, a diagnosis of a non-ST segment myocardial infarction (NSTEMI) was made. Coronary angiography (CA) showed the entire coronary circulation arising from the right Valsalva sinus, from a single ostium (Figure 1A). Contrast enhanced CT confirmed the diagnosis (Figure 1B).
(A) Lateral view. Shows the retroaortic course of anomalous coronary artery. IVP, posterior interventricular coronary artery. (B) Caudal left anterior oblique view.
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F2
The large RCA (5mm) and LAD showed no signs of stenosis, coursing behind the aortic bulb and towards the interventricular sulcus (Figure 2).