The Role of Computed Tomography Coronary Angiography in the Management of Coronary Anomalies

Congenital abnormalities of coronary arteries are an uncommon cause of sudden cardiac death and are difficult to detect at coronary angiography. We describe two patients with acute coronary syndrome and non-occlusive coronary artery disease in which a 64-multidetector computed tomography (MDCT) coronary angiography showed the presence of a malignant coronary anomaly. Sixty-four-MDCT with the possibility of 3D reconstructions allows for easier diagnosis of coronary anomalies and provides essential details necessary for operative intervention. doi: 10.1111/jocs.12040 (J Card Surg 2013;28:33-36) Congenital abnormalities of coronary arteries may be found incidentally in 0.3% to 1% of healthy individuals. 1 They are an uncommon but important cause of chest pain, myocardial ischemia, and syncope and, above all, they carry a high risk for sudden cardiac death (up to 30% of patients), particularly before 35 years of age. 2 The detection and characterization of these anomalies is crucial for the management of these patients. We describe two cases of patients with angina but non- significant coronary artery disease at angiography in which the coronary anomaly was diagnosed using a 64- MDCT(LightSpeedVCT,GeneralElectrics,Milwaukee, WI). The usefulness of this non-invasive diagnostic tool inthediagnosisofthecoronaryanomaliesisthesubject of this clinical review.