Navigating ALCA-R Complexity: Clinical Presentation, Imaging, and Management
Date Issued
2024-04
Author(s)
Abstract
This case study explores the diagnostic challenges and management of
Aberrant Left Coronary Artery Arising from the Right Coronary Sinus (ALCAR), a rare coronary anomaly. Through advanced cardiac imaging, including
coronary angiography and CT coronary angiography, the report highlights
the importance of accurate diagnosis in a 69-year-old male with recurrent
chest pain during exercise.
ALCA-R, though less common, presents unique diagnostic challenges and is
considered more perilous than its counterpart. With a prevalence of
approximately 0.15%, ALCA-R exhibits diverse anatomical variations,
emphasizing the role of advanced cardiac imaging in classification and
management decisions.
A 69-year-old male with recurrent chest pain during exercise underwent
coronary angiography and CT coronary angiography, revealing an ALCA-R
with a sub-pulmonic subtype. The anomalous artery traversed the right
ventricular outflow tract, pulmonary infundibulum, and interventricular
septum.
Recognition of ALCA-R's clinical implications is crucial, especially in patients
with recurrent chest pain during exertion. Classified by course, ALCA-R
includes categories like inter-arterial, intra-myocardial, retro-aortic, and
anterior. Accurate diagnosis through advanced imaging guides intervention
and risk assessment.
A multidisciplinary team evaluated the patient, including cardiologists and
cardiac surgeons. Treatment options, including potential surgical correction,
were discussed based on specific anatomical considerations identified
through imaging.
This case study provides insights into the clinical and imaging aspects of
ALCA-R, emphasizing the importance of accurate diagnosis and
interdisciplinary collaboration for optimal patient care. The goal is to
enhance awareness and proactive management of rare coronary anomalies.
Aberrant Left Coronary Artery, ALCA-R, sub-pulmonic type, Coronary
Anomalies, Coronary CT Angiography.
Aberrant Left Coronary Artery Arising from the Right Coronary Sinus (ALCAR), a rare coronary anomaly. Through advanced cardiac imaging, including
coronary angiography and CT coronary angiography, the report highlights
the importance of accurate diagnosis in a 69-year-old male with recurrent
chest pain during exercise.
ALCA-R, though less common, presents unique diagnostic challenges and is
considered more perilous than its counterpart. With a prevalence of
approximately 0.15%, ALCA-R exhibits diverse anatomical variations,
emphasizing the role of advanced cardiac imaging in classification and
management decisions.
A 69-year-old male with recurrent chest pain during exercise underwent
coronary angiography and CT coronary angiography, revealing an ALCA-R
with a sub-pulmonic subtype. The anomalous artery traversed the right
ventricular outflow tract, pulmonary infundibulum, and interventricular
septum.
Recognition of ALCA-R's clinical implications is crucial, especially in patients
with recurrent chest pain during exertion. Classified by course, ALCA-R
includes categories like inter-arterial, intra-myocardial, retro-aortic, and
anterior. Accurate diagnosis through advanced imaging guides intervention
and risk assessment.
A multidisciplinary team evaluated the patient, including cardiologists and
cardiac surgeons. Treatment options, including potential surgical correction,
were discussed based on specific anatomical considerations identified
through imaging.
This case study provides insights into the clinical and imaging aspects of
ALCA-R, emphasizing the importance of accurate diagnosis and
interdisciplinary collaboration for optimal patient care. The goal is to
enhance awareness and proactive management of rare coronary anomalies.
Aberrant Left Coronary Artery, ALCA-R, sub-pulmonic type, Coronary
Anomalies, Coronary CT Angiography.
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