Anomalous Origin of the Left Coronary Artery From the Right Coronary Sinus Diagnosed by Electron Beam Computerized Tomography
This picture was obtained in a 61-year-old female patient referred for myocardial infarction of the left anterior ventricular wall. A coronary angiogram demonstrated nonsignificant coronary artery disease, but catheterization of the left coronary artery was difficult and raised the suspicion of anomalous aortic origin of the left main coronary artery.
This 3-mm-thick axial scan was acquired with an Electron Beam Computerized Tomograph (Imatron) during intravenous infusion of contrast medium. The 100-ms acquisition time eliminates motion artifacts related to cardiac movement and allows constant visualization of both the origin of the coronary arteries and their relation to the great vessels. In this case, the origin of the left coronary artery from the right coronary sinus with passage of the left main coronary trunk between the aorta and the pulmonary artery is demonstrated. The mechanism of myocardial infarction in such cases is unknown, but it may be related to “squeezing” of the left main coronary artery between the two vessels.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Heart Institute, 6720 Bertner, MC 4-265, Houston, TX 77030.
- Received July 7, 1994.
- Accepted September 29, 1994.
- Copyright © 1995 by American Heart Association