Angioplastía primaria en infarto agudo al miocardio en arteria coronaria derecha con origen anómalo: Caso clínico / Primary angioplasty for acute myocardial infarction with an anomalous origin of right coronary artery: Report of one case

Anomalous origin of coronary arteries is a rare anatomical defect and its association with acute myocardial infarction is unusual. We report a 58-year-old male with ST-Segment elevation. Myocardial infarction of the inferior wall caused by a total occlusion on the proximal third of an anomalous right coronary artery, that was effectively treated with primary angioplasty with stent placement. The patient had a favorable outcome and is asymptomatic after five years of follow up.

The study of diagnostic accuracy of prospectively electrocardiogram-triggered high-pitch spiral acquisition using Flash dual-source CT for the assessment of coronary stenoses / 中华放射学杂志

Objectives To prospectively investigate the diagnostic accuracy,image quality and radiation doses of prospectively ECG-triggered high-pitch spiral acquisition computed tomography coronary angiography (CTCA) using Flash dual-source CT for the diagnosis of significant coronary stenoses.Methods Seventy-three patients underwent both CTCA and CCA.CTCA was performed using a Flash dual-source CT system with data acquisition at a high-pitch of 3.4.CCA served as the standard of reference.Radiation dose values were calculated using the dose-length product.Results There were 925 vessel segments in 73 patients.(1)Diagnostic accuracy: the sensitivity,specificity and positive and negative predictive values were 93.2％ (164/176),96.4％ (722/749),85.9％ (164/191),98.4％ (722/734) for segment assessment and 98.4％ ( 123/125 ),87.4％ ( 83/95 ),91.1％ ( 123/135 ),97.6％ ( 83/85 ) for vessel assessment and 100％ (44/44),89.7％ ( 26/29 ),93.6％ ( 44/47 ),100％ ( 26/26 ) for patient assessment.( 2 ) Image quality: there were 2 coronary segments of right coronary artery and one segment of left circumflex artery with non-diagnostic image quality.There was no non-diagnostic image quality in left anterior descending artery.(3) Radiation dose: the effective radiation dose was ( 1.14 ± 0.10) mSv.Conclusions CTCA using the prospectively ECG-triggered high-pitch spiral mode of the Flash dual-source CT system is associated with high diagnostic accuracy for the assessment of coronary artery stenoses at low dose.