Role of coronary computed tomography angiography for the diagnosis of coronary anomalies

Abstract

Coronary anomalies are rare heart diseases that can cause sudden cardiac death, especially in young individuals. Coronary computed tomography angiography delivers a three-dimensional view of excellent quality with information of the origin, course and anatomic relationships of the anomalous vessel, allowing differentiation between benign and malignant variants, entities that require different management and treatment. To show that coronary computed tomography angiography is the non-invasive technique of choice for the evaluation of a coronary anomaly due to its high diagnostic accuracy. Between 2008 and 2014, 368 coronary computed tomography angiographies were carried out. Six (1.6%) patients had a coronary anomaly. The age of these six patients ranged from 38 to 82 years (five were women). The coronary computed tomography angiography was requested due to cardiac symptoms (angina and dyspnea) in two patients, after a selective coronary arteriography to obtain additional information of the coronary anomaly in three patients, and after a cardiorespiratory arrest in one patient. Three patients had an anomaly of the right coronary artery, two patients had an anomaly of the left coronary artery and one patient had absent left main coronary artery. In five patients the coronary anomaly was malignant. Coronary computed tomography angiography is a robust diagnostic method to evaluate patients with suspected coronary anomalies.