Coronary Artery Anomaly in a Symptomatic Adult Patient

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J INVASIVE CARDIOL 2024. doi:10.25270/jic/24.00203. Epub July 25, 2024.

A 55-year-old man was referred to our department for further evaluation of an episode of syncope with significant elevation of troponin (2.800ng/L) after strenuous exercise. We performed coronary angiography, which showed a single coronary artery originating from the right coronary sinus. A significant coronary artery disease was excluded (Figure A-C). 

Computed tomography-coronary angiography confirmed the common origin of the left main coronary artery (LM) and the right coronary artery, and revealed an anomalous, long interarterial course of the LM between aortic root and the pulmonary artery (Figure D and E). 

The patient was evaluated by the Heart Team and a stress echocardiogram with dobutamine was performed, which was negative for ischemia. We prescribed further pharmacological treatment with b-blocker (5 mg of bisoprolol once per day) and strict exercise restriction.

Affiliations and Disclosures

Eleftherios Kontopodis, MD; Maria Kachrimani, MD; Panagiotis Tzortzakis, MD; Kostantinos Vardakis, MD

From the Department of Cardiology, Creta InterClinic, Heraklion, Greece.

Disclosures: The authors report no financial relationships or conflicts of interest regarding the content herein.

Address for correspondence: Eleftherios Kontopodis, MD, Department of Cardiology, Creta InterClinic, Minoos 63, GR 71304, Heraklion, Crete, Greece. Email: ekontopodis@gmail.com