Abstract
Role of coronary CTA and dual-energy CT in diagnosis of anomalous course of two coronary arteries in patient with apical hypertrophic cardiomyopathy
Highlights
Congenital anomalies of coronary arteries are relatively frequently found in general population [1,2]
We are presenting a case of rare congenital coronary anomaly combined with the apical form of Hypertrophic cardiomyopathy (HCM) in patient with initial suspicion to myocardial ischemia and coronary artery disease (CAD)
ECG (Figure 1) revealed sinus tachycardia, prominent signs of left ventricular (LV), myocardial hypertrophy with inverted T waves in I,II, aVL and V2-6 leads with mild ST-segment depression
Summary
Congenital anomalies of coronary arteries are relatively frequently found in general population (their incidence reaches 0.2-0.9%) [1,2]. We are presenting a case of rare congenital coronary anomaly combined with the apical form of HCM in patient with initial suspicion to myocardial ischemia and coronary artery disease (CAD). ECG (Figure 1) revealed sinus tachycardia (heart rate 100 bpm), prominent signs of left ventricular (LV) , myocardial hypertrophy with inverted T waves in I,II, aVL and V2-6 leads with mild ST-segment depression. Sinitsyn VE (2016) Role of coronary CTA and dual-energy CT in diagnosis of anomalous course of two coronary arteries in patient with apical hypertrophic cardiomyopathy. CTA confirmed the presence of apical myocardial hypertrophy compatible with the diagnosis of apical HCM (Figure 3). MDE CT revealed strong enhancement of hypertrophied apical segments of LV myocardium indicative of intramyocardial fibrosis in HCM (Figure 5). Longterm treatment with cardioselective beta-blockers and control of BP and HR together with follow-up by the cardiologist were selected for further patient management
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