Diagnosis and demonstration of single coronary artery by multidetector CT angiography: series of two cases
Abstract Background Single coronary artery (SCA) is a rare anomaly, usually diagnosed incidentally during coronary artery angiogram. Individuals with this anomaly mostly remain asymptomatic while some present with symptoms such as chest pain, dyspnoea and even sudden death. The origin and the proxim...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-08-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
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| Online Access: | https://doi.org/10.1186/s43055-022-00870-5 |
| _version_ | 1811283777227325440 |
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| author | Neha Singh Yashraj Gupta Bhanupriya Singh Gaurav Raj Agrawal Subhash Rajput |
| author_facet | Neha Singh Yashraj Gupta Bhanupriya Singh Gaurav Raj Agrawal Subhash Rajput |
| author_sort | Neha Singh |
| collection | DOAJ |
| description | Abstract Background Single coronary artery (SCA) is a rare anomaly, usually diagnosed incidentally during coronary artery angiogram. Individuals with this anomaly mostly remain asymptomatic while some present with symptoms such as chest pain, dyspnoea and even sudden death. The origin and the proximal course of anomalous coronary artery are the main prognostic factors. Several classification systems have been proposed based on the site of origin and anatomical distribution of anomalous artery. Coronary computed tomography angiography has become the reference method for such an assessment noninvasively. Herein, we report a series of two cases of SCA diagnosed on CT angiography. In one case it was single left coronary artery associated with other congenital cardiac anomalies, whereas in other it was single right coronary artery and was an isolated anomaly. Case presentation Our first case was of a 19-year-old female who presented with chest pain and dyspnoea. Transthoracic Echocardiography (TTE) features were suggestive of Tetralogy of Fallot (TOF) with infective endocarditis. Cardiac CT angiography revealed the presence of a large SCA arising from left aortic sinus with absence of normal origin of right coronary artery (RCA). This artery was dividing into and supplying different coronary arterial territories with pre-pulmonic course of RCA. The patient underwent Aortic valve replacement with pulmonary Commissurotomy and improved in post-operative period. Our second case was of a 50-year-old man with complaints of breathlessness and normal ECG and Echocardiography examination findings. Coronary CT angiography revealed the presence of SCA arising from right aortic sinus and supplying the territories of both RCA and Left coronary artery (LCA). The patient was managed conservatively with emphasis on aggressive control of risk factors. Conclusions SCA is a rare anomaly and may lead to catastrophic life threatening complications. The accurate delineation of the origin and course of the anomalous vessel is of paramount importance while planning surgical intervention. Management usually involves a multi-disciplinary approach with cardiologists and cardiac surgeons aiming for deciding an individual plan based on presentation and anatomy of each case. |
| first_indexed | 2024-04-13T02:18:45Z |
| format | Article |
| id | doaj.art-012e714b856448cbba89b13f312b59de |
| institution | Directory Open Access Journal |
| issn | 2090-4762 |
| language | English |
| last_indexed | 2024-04-13T02:18:45Z |
| publishDate | 2022-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj.art-012e714b856448cbba89b13f312b59de2022-12-22T03:07:04ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622022-08-015311710.1186/s43055-022-00870-5Diagnosis and demonstration of single coronary artery by multidetector CT angiography: series of two casesNeha Singh0Yashraj Gupta1Bhanupriya Singh2Gaurav Raj Agrawal3Subhash Rajput4Department of Radiodiagnosis and Imaging, Dr. Ram Manohar Lohia Institute of Medical SciencesDepartment of Radiodiagnosis and Imaging, Dr. Ram Manohar Lohia Institute of Medical SciencesDepartment of Radiodiagnosis and Imaging, Dr. Ram Manohar Lohia Institute of Medical SciencesDepartment of Radiodiagnosis and Imaging, Dr. Ram Manohar Lohia Institute of Medical SciencesDepartment of Cardio-Thoracic and Vascular Surgery, Dr. Ram Manohar Lohia Institute of Medical SciencesAbstract Background Single coronary artery (SCA) is a rare anomaly, usually diagnosed incidentally during coronary artery angiogram. Individuals with this anomaly mostly remain asymptomatic while some present with symptoms such as chest pain, dyspnoea and even sudden death. The origin and the proximal course of anomalous coronary artery are the main prognostic factors. Several classification systems have been proposed based on the site of origin and anatomical distribution of anomalous artery. Coronary computed tomography angiography has become the reference method for such an assessment noninvasively. Herein, we report a series of two cases of SCA diagnosed on CT angiography. In one case it was single left coronary artery associated with other congenital cardiac anomalies, whereas in other it was single right coronary artery and was an isolated anomaly. Case presentation Our first case was of a 19-year-old female who presented with chest pain and dyspnoea. Transthoracic Echocardiography (TTE) features were suggestive of Tetralogy of Fallot (TOF) with infective endocarditis. Cardiac CT angiography revealed the presence of a large SCA arising from left aortic sinus with absence of normal origin of right coronary artery (RCA). This artery was dividing into and supplying different coronary arterial territories with pre-pulmonic course of RCA. The patient underwent Aortic valve replacement with pulmonary Commissurotomy and improved in post-operative period. Our second case was of a 50-year-old man with complaints of breathlessness and normal ECG and Echocardiography examination findings. Coronary CT angiography revealed the presence of SCA arising from right aortic sinus and supplying the territories of both RCA and Left coronary artery (LCA). The patient was managed conservatively with emphasis on aggressive control of risk factors. Conclusions SCA is a rare anomaly and may lead to catastrophic life threatening complications. The accurate delineation of the origin and course of the anomalous vessel is of paramount importance while planning surgical intervention. Management usually involves a multi-disciplinary approach with cardiologists and cardiac surgeons aiming for deciding an individual plan based on presentation and anatomy of each case.https://doi.org/10.1186/s43055-022-00870-5Single coronary arteryAnomalous coronary arteryCoronary artery anomaliesLipton classificationCT angiography |
| spellingShingle | Neha Singh Yashraj Gupta Bhanupriya Singh Gaurav Raj Agrawal Subhash Rajput Diagnosis and demonstration of single coronary artery by multidetector CT angiography: series of two cases The Egyptian Journal of Radiology and Nuclear Medicine Single coronary artery Anomalous coronary artery Coronary artery anomalies Lipton classification CT angiography |
| title | Diagnosis and demonstration of single coronary artery by multidetector CT angiography: series of two cases |
| title_full | Diagnosis and demonstration of single coronary artery by multidetector CT angiography: series of two cases |
| title_fullStr | Diagnosis and demonstration of single coronary artery by multidetector CT angiography: series of two cases |
| title_full_unstemmed | Diagnosis and demonstration of single coronary artery by multidetector CT angiography: series of two cases |
| title_short | Diagnosis and demonstration of single coronary artery by multidetector CT angiography: series of two cases |
| title_sort | diagnosis and demonstration of single coronary artery by multidetector ct angiography series of two cases |
| topic | Single coronary artery Anomalous coronary artery Coronary artery anomalies Lipton classification CT angiography |
| url | https://doi.org/10.1186/s43055-022-00870-5 |
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