einstein (São Paulo). 08/Nov/2019;18:eAI5174.
Common origin of the coronary arteries from the right sinus with intramyocardial course of the anterior descent artery
DOI: 10.31744/einstein_journal/2020AI5174
A 62-year-old patient referred to coronary angiotomography due to ischemic changes detected in an exercise stress test. The patient reported hypertension and dyslipidemia, both controlled with drug treatment and regular physical exercise. She didn’t have any cardiovascular complaints and her physical examination was unremarkable.
Coronary angiotomography showed common origin of coronary arteries through a short common trunk, emerging from the right Valsalva sinus and trifurcating into right coronary artery (RCA), circumflex artery (CxA) and anterior descending artery (ADA). The RCA had habitual course and gives rise to the posterior descending artery (right-dominance). The CxA had a small caliber and retroaortic course without luminal. The ADA had an important angulation in its origin, interarterial course in subvalvar plan and a long proximal intramyocardial segment, where it exhibited a reduction of its diameter, without plaques or parietal changes ( ).
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