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Stress test to STEMI: Utility of coronary CTA in the diagnosis and management of anomalous right coronary artery from the left coronary cusp
Authors:Anshuman Das MD  Ajay Joseph MD  Neeraj Jolly MD  Dinesh K. Kalra MD
Affiliation:1. Department of Medicine, Division of Cardiology, Section of Interventional Cardiology, Rush University Medical Center, Chicago, IL, USA;2. Advanced Cardiac Imaging, Rush University Medical Center, Chicago, IL, USA
Abstract:A 42‐year‐old woman presented to the emergency department with chest pain. Acute coronary syndrome was ruled out. During dobutamine stress echocardiography (DSE), she developed chest pain and inferior ST elevation. Emergent coronary angiography revealed no culprit lesions but did show an anomalous right coronary artery (RCA). Coronary CT angiography (CCTA) confirmed an anomalous RCA arising from the left coronary cusp with a slit‐like ostium and interarterial course (ARCA‐LCC‐IA). Herein, we review the extant literature on ARCA‐LCC‐IA, its clinical presentation, the vital role of CTA and MRI in its diagnosis, as well as challenges and controversies surrounding management.
Keywords:anomalous coronary arteries  anomalous origin of right coronary artery  computed tomography  coronary arteriography
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