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The sinister course of an intramural right coronary artery

Published online by Cambridge University Press:  19 July 2011

Deane L. S. Yim
Affiliation:
Bristol Congenital Heart Centre, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, United Kingdom
Mark C. K. Hamilton
Affiliation:
Department of Clinical Radiology, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, United Kingdom
Robert M. R. Tulloh*
Affiliation:
Bristol Congenital Heart Centre, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, United Kingdom
*
Correspondence to: Dr R. M. R. Tulloh, DM, FRCP, FRCPCH, Bristol Congenital Heart Centre, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8BJ, United Kingdom. Tel: +44 117 342 8176; Fax: +44 117 342 8857; E-mail: Robert.Tulloh@uhbristol.nhs.uk

Abstract

We report the case of an adolescent who was presented with long-standing exertional symptoms, and was diagnosed with an anomalous right coronary arterial origin arising above the commissural junction between the left and right aortic sinus, with inter-arterial and intramural compression. The precise origin of this lesion outside the aortic sinuses is unusual, and multi-detector computed tomography gave excellent definition and spatial resolution of the anomalous origin and course. It is crucial to have a high index of suspicion of exertional symptoms, as sudden death may be the first manifestation of an anomalous coronary artery.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 2011

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