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Anomalous right coronary origin from pulmonary artery in a 54 year old woman


  Case radiograph

Contributor: Dennis Ko, MD
 

Echo studies


Echo LPLA

Other imaging & studies


PA rad Lateral rad

51 yo African American presented to the hospital with chest pain. Her chest pain was atypical in nature without associated symptoms and was ruled out for myocardial infarction by enzymes. She has a past history of congestive heart failure with depressed ejection fraction of 25-30% but no further evaluation after treatment of congestive heart failure.

Exam: Vitals stable, Alert, looks well, Chest: Clear, CVS: S1 S2 no extra heart sounds, elevated JVD at 12 cm.

Lab Studies: EKG: Normal sinus rhythm, leftward axis, possible left and right atrial enlargement ECHO: Global depressed LV, EF: 30%, moderate TR, moderate pulmonary hypertension Right heart cath: RA 12, RV 60/28, PA mean 30, PCWP 26, no step up during saturation run Cath: mild disease at diagonal, anomalous right pulmonary artery from pulmonary artery CT Chest: With knowledge of the cath images, anomalous origin of the right coronary from the pulmonary artery was visible.

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