Author/Authors :
Alkhunaizi, Fatimah A. Department of Medicine - Johns Hopkins Hospital, Baltimore, MD, USA , Kapoor, Karan Department of Medicine - Division of Cardiology Johns Hopkins Hospital, Baltimore, MD, USA , Pallazola, Vincent Department of Medicine - Johns Hopkins Hospital, Baltimore, MD, USA , Shapiro, Edward P. Department of Medicine - Division of Cardiology Johns Hopkins Hospital, Baltimore, MD, USA , Johnston, Peter V. Department of Medicine - Division of Cardiology Johns Hopkins Hospital, Baltimore, MD, USA , Vaishnav, Joban Department of Medicine - Division of Cardiology Johns Hopkins Hospital, Baltimore, MD, USA , Gilotra, Nisha A. Department of Medicine - Division of Cardiology Johns Hopkins Hospital, Baltimore, MD, USA , Kilic, Ahmet Department of Surgery - Division of Cardiothoracic Surgery - Johns Hopkins Hospital, Baltimore, MD, USA , Rouf, Rosanne Department of Medicine - Division of Cardiology Johns Hopkins Hospital, Baltimore, MD, USA
Abstract :
A 46-year-old man was admitted with non-ST elevation myocardial infarction and newly diagnosed acutely decompensated heart
failure. Echocardiogram demonstrated left ventricular ejection fraction of 30% with basal inferior and inferolateral akinesis.
Coronary angiography showed mild diffuse coronary artery disease and an anomalous right coronary artery arising from the left
coronary cusp. Further imaging was consistent with ischemia in the right coronary distribution. Etiology of ischemia was
thought to be the anomalous right coronary artery, and surgical unroofing of the right coronary ostium was performed. Here,
we report a multimodality imaging approach, including cardiac magnetic resonance, cardiac computed tomographic
angiography, and single-photon emission computed tomography, to support the diagnosis and management of a patient with
anomalous right coronary artery arising from the left coronary cusp.
