Congenital Anomalous Course of Left Coronary Artery

"Thanks to the one-beat cardiac acquisition and ASIR-V, a confident and reproducible diagnosis of coronary arteries can be performed with very low dose, even at high heart rates.”

Dr. Fran Mikulicic

Clinical Case

Patient History

A man in his 40's with elevated coronary risk profile and atypical chest pain was referred to CT for risk stratification.


    One-beat cardiac acquisition:

    • 160 mm axial scanning with ECG gating

    • 100 kV and 256 mA

    • BMI: 26

    • ASiR*-V1 to lower dose

    • 0.28 sec rotation speed

    • Heart rate: 69-72 BPM

    • DLP 37 mGy-cm

    • 0.52 mSv2

    • Exposure time: 0.28 sec



ConclusionThis congenital anomaly of the left coronary artery reveals a joint origin of the LMA and RCA from the right coronary cusp with interarterial course of the left main artery.This rare anomaly is associated with sudden cardiac death particularly during strenuous exercise.
For further evaluation a myocardial SPECT with exercise stress testing is planned to evaluate the relevance of the finding in this particular case.