| Popis: |
In this case presentation, a 20-year-old male patient with atypical chest pain underwent a coronary CT angiography using a 128-slice CT scanner (GE Healthcare Medical Systems, Revolution). The results revealed a rare coronary artery anomaly along with incidental cardiac pathologies. The coronary CT angiography showed that both the right coronary artery (RCA) and the left circumflex coronary artery (LCX) originated from a single root arising from the right coronary sinus. The LCX was found to be retroaortic and descending in the left atrioventricular groove. This specific configuration was classified as a type 2 variation of the LCX, in which both the RCA and LCX arise from the same root. In addition to the coronary anomaly, two other incidental cardiac pathologies were observed. The first was a left atrial septal pouch, which is a recess at the atrium formed by incomplete fusion of the cranial segments of the septum primum and septum secundum. This atrial septal pouch is known to be a predisposition for thrombosis. The second incidental finding was a small millimeter-sized diverticulum located at the superior wall of the left atrium. Atrial diverticula are cyst-like extensions that protrude from the cardiac chambers and contain only a muscle layer. The prevalence of atrial diverticula has been reported to range between 19% to 41% and is often diagnosed incidentally. The case presentation emphasizes the importance of using coronary CT angiography as a superior modality for diagnosing coronary artery anomalies and detecting incidental cardiac pathologies. Such imaging techniques allow for detailed descriptions of the coronary artery anomalies, their origin, course, and relationship with other cardiac structures. In conclusion, coronary artery anomalies are rare but significant contributors to sudden cardiac deaths. This case highlights the potential of coronary CT angiography in diagnosing not only coronary anomalies but also incidental cardiac pathologies, which could have clinical implications and help guide appropriate management and treatment decisions. |
