title: Anomalous coronary origin: from suspicion to surgical revascularization.
abstract: Congenital anomalies of the coronary arteries are uncommon and can present a diagnostic challenge. The authors present the case of a patient with recurrent chest pain during exertion admitted for acute coronary syndrome. Coronary angiography revealed no coronary lesions but showed that the right coronary artery originated from the anterolateral aortic wall, above the sinuses of Valsalva, leading to suspicion of compression by the pulmonary artery, confirmed by CT angiography. The patient underwent surgical revascularization with a good result. The authors highlight the need to consider compression of an anomalous coronary artery by the pulmonary artery in the differential diagnosis of recurrent chest pain on exertion and acute myocardial infarction without significant coronary stenosis.
authors.affiliation: Serviço de Cardiologia, Hospital de Braga, Braga, Portugal. Electronic address: katarinafvieira@gmail.com.
authors.forename: Catarina
authors.initials: C
authors.lastname: Vieira
authors.affiliation: Serviço de Cardiologia, Hospital de Braga, Braga, Portugal.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Nabais
authors.affiliation: Serviço de Cardiologia, Hospital de Braga, Braga, Portugal.
authors.forename: Alberto
authors.initials: A
authors.lastname: Salgado
authors.affiliation: Serviço de Cardiologia, Hospital de Braga, Braga, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Salomé
authors.affiliation: Hospital Cuf, Porto, Portugal.
authors.forename: Paulino
authors.initials: P
authors.lastname: Sousa
authors.affiliation: Serviço de Radiologia, Hospital de São João, Porto, Portugal.
authors.forename: António
authors.initials: A
authors.lastname: J Madureira
authors.affiliation: Centro de Cirurgia Cardiotorácica, Hospital de São João, Porto, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Pinho
authors.affiliation: Centro de Cirurgia Cardiotorácica, Hospital de São João, Porto, Portugal.
authors.forename: Jorge
authors.initials: J
authors.lastname: Casanova
mesh_terms: D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009204:Myocardial Revascularization; D011859:Radiography
keywords: Angio-tomografia computorizada coronária; Anomalous origin of coronary arteries; Coronary computed tomography angiography; Origem coronária anómala; Revascularização cirúrgica; Surgical revascularization