Rare congenital coronary artery anomalies diagnosed by coronary CT angiography: A 4-case series

Q4 Medicine

Radiology Case Reports Pub Date : 2025-10-04 DOI:10.1016/j.radcr.2025.09.029

Le Van Lam MD, Truong Minh Thuong MD, Tran Quyet Thang MD, Vu Thi Thuy Huong MD, Tran Minh Vu MD, Hoang Phan Thu Ha BSc, Duong Dinh Tuan Linh BSc, Phung Xuan Thinh BSc

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引用次数: 0

Abstract

Congenital coronary artery anomalies (CCAAs) are uncommon but may cause myocardial ischemia, arrhythmias, or sudden cardiac death. Coronary computed tomography angiography (CCTA) provides precise, noninvasive assessment of these variants. We report 4 rare CCAA cases detected by CCTA: (1) coronary cameral fistula from the left coronary artery (LCA) to the left ventricle with associated myocardial bridging; (2) interarterial course of the right coronary artery (RCA) between the aorta and pulmonary artery; (3) congenital absence of the RCA with a dominant left system; and (4) dual RCAs. Three patients presented with exertional chest pain, one was found incidentally. All were managed conservatively based on absence of hemodynamic compromise and low ischemic risk; symptoms resolved or improved on follow-up (3-12 months). This series illustrates the spectrum of rare CCAAs and emphasizes CCTA’s role in differentiating malignant from benign variants, guiding management, and avoiding unnecessary interventions.

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冠状动脉CT血管造影诊断罕见先天性冠状动脉异常：附4例报告

先天性冠状动脉异常（CCAAs）并不常见，但可能导致心肌缺血、心律失常或心源性猝死。冠状动脉计算机断层血管造影（CCTA）提供了这些变异的精确、无创评估。我们报告4例CCTA检测到的罕见CCAA病例：(1)左冠状动脉（LCA）至左心室的冠状动脉摄像瘘伴心肌桥接；(2)主动脉与肺动脉之间的右冠状动脉（RCA）的动脉间程；(3)先天性RCA缺失，左侧系统占优势；(4)双rca。3例患者表现为运动性胸痛，1例为偶然发现。所有患者均采用保守治疗，无血流动力学损害和低缺血性风险；随访（3-12个月）症状缓解或改善。本系列文章阐述了罕见ccaa的频谱，并强调CCTA在区分恶性和良性变异、指导治疗和避免不必要干预方面的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiology Case Reports Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

1.10

自引率

0.00%

发文量

1074

审稿时长

30 days

期刊介绍： The content of this journal is exclusively case reports that feature diagnostic imaging. Categories in which case reports can be placed include the musculoskeletal system, spine, central nervous system, head and neck, cardiovascular, chest, gastrointestinal, genitourinary, multisystem, pediatric, emergency, women''s imaging, oncologic, normal variants, medical devices, foreign bodies, interventional radiology, nuclear medicine, molecular imaging, ultrasonography, imaging artifacts, forensic, anthropological, and medical-legal. Articles must be well-documented and include a review of the appropriate literature.