Anomalous Left Main Coronary Artery: Exclusion of a Malignant Variant using Coronary CT Angiography

M. Goeller, MD; M. Marwan, MD; M. Hell, MD; A. Schuhbaeck, MD; M. Troebs, MD, and S. Achenbach, MD;
Department of Internal Medicine 2, Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany

A 62-year-old female patient suffering from hypertension and obesity (body mass index 31.6 kg/m2) was referred to a nearby hospital for exclusion of coronary artery disease (CAD) by invasive coronary angiography. The patient suffered from exertional dyspnea, chest discomfort and palpitations in recent weeks. Her physical examination was unremarkable and the electrocardiogram as well as the transthoracic echocardiography were normal. Invasive coronary angiography revealed mild atherosclerosis without hemodynamic relevant stenosis. Furthermore the left main coronary artery (LM) showed an anomalous course and the patient was referred to our department for coronary CT angiography (CTA) to further clarify the course of the LM in relation to the adjacent large vessels to rule out malignant coronary anomalies.