"Malignant" anomalous interarterial course of the left coronary artery
Diagnosis certain
Presentation
Chest pain and palpitations.
Patient Data
Age: 40 years
Gender: Female
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Anomalous left main coronary artery origin arising from the right aortic sinus with an interarterial course between the aorta and the pulmonary artery. The left main trifurcates into the left anterior descending, a ramus intermedius branch and the circumflex coronary artery which are normal in course and caliber. Normal right coronary artery origin, course and caliber. Right dominant system.
Case Discussion
Most coronary artery anomalies are "benign", but a "malignant" anomalous vessel course between the aorta and the pulmonary artery puts the patient at risk for sudden death, especially if the left main coronary artery is involved.
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