Abstract
Congenital coronary artery anomalies are rare but well-described causes of chest pain and, in some cases, link to sudden cardiac death. With the spread of advanced imaging techniques, the number of incidental findings is staggering, but little information has been given in order to rule out potential malignant cases in symptomatic adult patients. Here, we describe a case of an anomalous course of the coronary artery with an acute (<45°) take-off angle, as well as an inter-arterial course between a dilated ascending aorta and a dilated pulmonary artery, and how we could manage this patient in our clinical practice.
Highlights
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A 48-year-old woman with hypertension, type 2 diabetes mellitus, history of breast cancer treated with radiation and chemotherapy presented with atypical chest pain
The calcium (Agatston) score was 0 in total, and no plaques were seen on the coronary arteries
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Due to the patient’s clinical pretest probability and the referral atypical chest pain, a coronary computed tomography angiography (CCTA) 128-MDCT (preceded by infusion of metoprolol for pre-medication) was requested in order to exclude a coronary artery atherosclerosis disease.
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