PMC3658238_01
Resting electrocardiogram showing no abnormalities.
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A 53-year-old man with a history of hypertension, dyslipidemia, and stable angina CCS 2 underwent an exercise tolerance test which was positive for stress-induced ischemia (Figure 1A and 1B).
Electrocardiogram showing ST segment depression mainly in leads I, II, aVL, and aVF.
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The patient underwent coronary angiography through the right femoral artery, which revealed aortic coarctation (Figure 2) and a right dominance pattern, with an abnormal right coronary origin, arising from the left coronary artery branch, with no obstructive lesions (Figure 3).
Angiogram demonstrating aortic coarctation.
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The patient underwent coronary angiography through the right femoral artery, which revealed aortic coarctation (Figure 2) and a right dominance pattern, with an abnormal right coronary origin, arising from the left coronary artery branch, with no obstructive lesions (Figure 3).
Coronary angiography revealing a single coronary ostium. The right coronary arises from the left coronary main branch. . Abbreviations: LMS, left main stem; Cx, circumflex artery; RCA, right coronary artery; LAD, left anterior descending artery.
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Although coronary angiography did not show any significant obstructive lesions, a CT coronary angiogram (using a clinical scanner with 64 data channels) was performed, which revealed an anomalous right coronary course, passing between the aorta and the exit tract of the right ventricle (interarterial, Figure 4), and confirmed the aortic coarctation (Figure 5).
CT angiogram showing the right coronary course between the aorta and pulmonary artery. . Abbreviations: LMS, left main stem; Cx, circumflex artery; RCA, right coronary artery; LAD, left anterior descending artery; RC, right coronary.
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Although coronary angiography did not show any significant obstructive lesions, a CT coronary angiogram (using a clinical scanner with 64 data channels) was performed, which revealed an anomalous right coronary course, passing between the aorta and the exit tract of the right ventricle (interarterial, Figure 4), and confirmed the aortic coarctation (Figure 5).