- Case Report
- Open Access
Cardiovascular magnetic resonance angiography for the detection of anomalous coronary arteries: a case report
© Chatzidou et al.; licensee Cases Network Ltd. licensee BioMed Central Ltd. 2009
- Received: 24 March 2009
- Accepted: 14 August 2009
- Published: 15 September 2009
Coronary artery anomalies occur in approximately 0.3% to 0.8% of the population, and include morphological variants of origin, course, or termination. Detection of these types of anomalously originating coronary arteries is crucial for therapeutic intervention.
- Cardiovascular Magnetic Resonance
- Left Anterior Descend
- Right Coronary Artery
- Left Main Coronary Artery
- Pulmonary Trunk
Coronary magnetic resonance angiography (CMRA) appears to be a useful modality in the imaging of the proximal course of anomalous coronary arteries. We report a case of an anterior course of the LMCA in relation to the pulmonary trunk, highlighting the usefulness of cardiac MRA in detecting the anomalously originated coronary arteries.
Coronary artery anomalies occur in approximately 0.3% to 0.8% of the population, and include morphological variants of origin, course, or termination. Not all anomalies will have sequelae that serious. The pattern with proximal coronary artery segments crossing between the aorta and the pulmonary trunk has been reported to be potentially lethal . The treatment of the anomaly originating LMCA from the RSOV is controversial and mainly based on observations . Basically the three benign forms (Septal course along the floor of the right ventricle, anterior right ventricle free wall course, Retro-aortic course) do not require specific interventions, while the intra-arterially crossing LMCA may warrant surgical repositioning, especially if associated with objective evidence of ischemia .
Detection of these types of anomalously originating coronary arteries is important for clinical intervention. With the current standard technique, ie, conventional coronary angiography, the exact proximal course of anomalous coronary arteries may be difficult to determine . Misdiagnosis has been reported to occur in up to 50% of patients. CMRA is a novel noninvasive technique that has proved to be accurate in the imaging of proximal coronary anatomy . CMRA appears to be a very useful adjunct coronary angiography and, with confirmation of our results in larger series, might even be considered a new gold standard in the imaging of the proximal course of anomalous coronary arteries. In this particular patient group, CMRA allowed precise delineation, monitoring its progression, and potentially evaluating the effects of therapeutic intervention.
Written informed consent was obtained from the patient for publication of the manuscript and figures. A copy of the written consent is available for review by the Editor-in-Chief of this journal. The ethnic origin of the patient described in the present report is Greece.
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