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(Circulation. 1998;97:219.)
© 1998 American Heart Association, Inc.

Images in Cardiovascular Medicine

Noninvasive Imaging of Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

Seiki Hamada, MD; Norihiko Yoshimura, MD; ; Makoto Takamiya, MD

From the Department of Radiology, National Cardiovascular Center, Osaka, Japan.

Correspondence to Seiki Hamada, MD, Department of Radiology, Osaka University Medical School, 2-2, Yamadaoka, Suita, Osaka 565, Japan.

Electron beam computerized tomography (EBCT) during intravenous administration of contrast medium showed an anomalous origin of the left coronary artery from the pulmonary artery, sometimes known as the Bland-White-Garland syndrome. This 28-year-old woman presented with chest pain caused by progressive myocardial ischemia. In this case, a right coronary arteriogram confirmed an enlarged right coronary artery, and both the left anterior descending branch and the circumflex artery were supplied by collateral circulation. The left main artery was connected with the pulmonary trunk during the late phase of the right coronary arteriogram. These axial EBCT images (Figure) were performed with 3-mm thickness and 100-ms acquisition time. Cardiac motionless images allow clear visualization of both the anomalous origin of the left main coronary trunk and enlarged right coronary artery. We can see that the left main trunk supplied the left anterior descending branch and circumflex artery.

View larger version (111K): [in this window] [in a new window]   Figure 1. Serial EBCT axial view of anomalous origin of left coronary artery from pulmonary trunk. A through C, Left coronary artery (arrows) with its origin at pulmonary trunk. D, Dilated right coronary artery (arrow) with its origin at aortic root.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to Dr Hugh McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner, MC1-267, Houston, TX . . . [Full Text of this Article]

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