Anomalous Origin of the Right Coronary Artery from the Left Sinus Valsalva with Coronary Ectasia

Nihat Söylemez, Recep Demirbağ, Tayfun Hazırolan, Onur AkpınarP
DOI: 10.4236/ijcm.2011.23043                

Abstract

The abnormal origin of the right coronary artery from the left aortic sinus coursing between the aorta and the pulmonary trunk is a rare congenital anomaly. It may remain asymptomatic or may result in cardiac morbidity or mortality. In the past, an anomalous origin of the right coronary artery from the left sinus of Valsalva was considered a benign finding; it is now evident that this anomaly can be associated with atypical chest pain, myocardial ischemia, and sudden death. We thought that; the diagnosis of left sinus Valsalva aneurysm, described by transtorasic echocardiography and transeusophageal echocardiography, might need demonstrated advanced scanning techniques.

Keywords

Congenital Anomaly, Coronary Ectasia, Echocardiography, Multi Detector Computerize Tomography

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary angiography. Ca- theter Cardiovasc Diagn 1990; 21: 28-40.
[2]	Kimbiris D, Iskandrian AS, Segal BL, Bemis CE. Ano- malous aortic origin of coronary arteries. Circulation 1978; 58: 606-15.
[3]	White NK, Edwards JE. Anomalies of the coronary arteries. Report of four cases. Arch Pathol 1948; 45; 766-71.
[4]	Taylor AJ, Rogan KM, Virmani R. Sudden cardiac death associated with isolated congenital coronary artery ano- malies. J Am Coll Cardiol 1992; 20: 640-7.
[5]	Kaku B, Kanaya H, Ikeda M, Uno Y, Fujita S, Kato F, et al. Acute inferior myocardial infarction and coronary spasm in a patient with an anomalous origin of the right coronary artery from the left sinus of Valsalva. Jpn Circ J 2000; 64: 641-3.
[6]	Serota H, Barth C, Seuc CA, Vandormael M, Aguirre F, Kern MJ. Rapid identification of the course of anomalous coronary arteries in adults: The ‘dot and eye’ method. Am J Cardiol 1990; 65: 891- 8.
[7]	Haramati LB, Glickstein JS, Issenberg H Haramati N, Crooke GA. MR imaging and CT of vascular anomalies and connections in patients with congenital heart disease: Significance in surgical planning. Radio Graphics 2002; 22: 337-49.
[8]	Bunce NH, Lorenz CH, Keegan J, Lesser J, Reyes EM, Firmin DN, et al. Coronary artery anomalies: Assessment with free-breathing three-dimensional coronary MR angiography. Radiology 2003; 227: 201-8.
[9]	Achenbach S, Giesler T, Ropers D, Ulzheimer S, Derlien H, Schulte C, et al. Detection of coronary artery stenoses by contrast-enhanced, retrospectively electrocardiographically-gated, multislice spiral computed tomography. Circulation 2001; 103: 2535-8.
[10]	Sato Y, Mitsui M, Takahashi H, Miyazawa T, Okabe H, Inoue F,et al. A giant left circumflex coronary artery-right atrium arteriovenous fistula detected by multislice spiral computed tomography. Heart Vessels 2004; 19: 55-6.