Anomalous Origin of the Right Coronary Artery from the Pulmonary Artery
Song Peng, Huaping Liu
Radiology . 2021 Sep 28;211186. doi: 10.1148/radiol.2021211186. Online ahead of print.
An 80-year-old woman was diagnosed with poorly differentiated gastric adenocarcinoma. Preoperative electrocardiography showed a complete right bundle branch block. Coronary CT angiography showed an anomalous origin of the right coronary artery from the pulmonary artery, collateralization between the left coronary artery and the right coronary artery, and a coronary steal phenomenon, which is caused by low pulmonary artery pressure and blood flowing back from the coronary artery to the pulmonary artery (1) (Figure, Movie [online]). The patient’s systolic and diastolic left ventricular function at coronary CT angiography, pulmonary arterial pressure at catheterization, and troponin blood levels were normal. The patient’s left coronary artery was able to supply the entire heart without causing symptoms, mainly because of the rich collateral circulation between the left coronary artery and the right coronary artery, normal pulmonary artery pressure, and mild coronary atherosclerosis (2). She underwent partial gastrectomy and recovered uneventfully.
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