A rare case of isolated single coronary artery, Lipton's type LIIB diagnosed by computed tomography coronary angiography.

Single coronary artery (SCA) is a very rare coronary artery anomaly of origin and course with a reported prevalence of only 0.024%-0.066% among patients undergoing routine coronary angiography. The majority of the individuals remain asymptomatic and thus SCA is found only incidentally on conventional or computed tomography coronary angiography done for other reasons. A minority of the patients may have non-specific cardiac symptoms (such as ischemic pain, tachycardia, etc.) or even sudden death. SCA can occur in isolation or in association with other congenital cardiac defects like such as persistent truncus arteriosus, tetralogy of Fallot (TOF), pulmonary atresia, transposition of great vessels (TGA), ventricular septal defect (VSD), coronary arteriovenous fistula (AVF), patent foramen ovale (PFO) and bicuspid aortic valve. We present a case of 50 years male with incidental finding of SCA arising from the left coronary sinus which had an inter-arterial course before branching (SCA Type: LIIB based on the Lipton-Yamanaka classification) which was revealed on computed tomography coronary angiography (CTCA) performed after the patient complained of infrequent chest pain. Management of the diagnosed cases can be either conservative, stent placement or surgical correction based on the symptomatology and clinico-lab findings.

Anomalous origin of left coronary artery from pulmonary artery (ALCAPA): A case report.

Anomalous origin of left coronary artery from pulmonary artery (ALCAPA) also known as Bland-White-Garland Syndrome is a rare anomaly of coronary arteries comprising of 0.25%-0.5% of all congenital heart defects with a prevalence of 1 in every 300,000 live births. Its clinical significance lies in the possibility of resultant coronary steal phenomenon with a left-to-right shunt causing aberrant left ventricular perfusion which may ultimately lead to myocardial ischemia and infarction in children having the abnormality. ALCAPA may manifest as an isolated defect but in 5% of cases it may be associated with other cardiac anomalies such as atrial septal defect, ventricular septal defect, and aortic coarctation. We present a case of 7 years female with ALCAPA with collaterals between RCA and LCA and additional findings of juxtaposition of left atrial appendage. Juxtaposition of atrial appendage is associated with some major congenital heart diseases, transposition of great vessels being the common one. In our case, however, juxtaposition of left atrial appendage is associated with ALCAPA. Surgery is the definite treatment modality for ALCAPA available till date. Early diagnosis of ALCAPA with the help of multislice CT angiography is always good for the patient to prevent the possible grave consequences.

Spectrum of imaging findings in Takayasu arteritis-A case report.

Takayasu arteritis (TA) is an uncommon chronic granulomatous inflammatory disease often affecting the aorta and its branches. Early diagnosis is quite challenging due to nonspecific symptoms and unfamiliarity with the disease. We hereby present a case of a young female patient diagnosed with Type V Takayasu arteritis using several radiological imaging modalities such as color and spectral Doppler study and computed tomography angiography. A timely diagnosis of Takayasu arteritis however may improve the outcome such as irreversible target organ damage and poor prognosis with a decreased rate of complications.

Complete interruption of aortic arch diagnosed in adulthood: a case report.

Few patients with interrupted aortas survive into maturity, and the majority of instances are diagnosed in young children. There are only a few cases of this extremely rare total aortic interruption that survives into maturity, necessitating the substantial growth of collaterals to supply the descending aorta. Here, we describe a rare instance of an interrupted aorta in a 43-year male that presented in late adulthood with complete interruption of the aortic arch. The patient has remained symptom-free and without treatment. This case gives us an idea about how one can survive into adulthood with complete interruption of the aortic arch given that extensive collaterals are formed.

Infective endocarditis complicated by cerebral abscess and mycotic intracranial aneurysm: A case report.

Infective endocarditis (IE), is an infection of the endocardial surfaces of the heart, which primarily affects the valve leaflets, the mural endocardium, chordae tendinae and prosthetic valves among others. IE has various complications among which neurological complications include stroke, infected intracranial aneurysms, intracranial abscesses, meningitis, encephalopathy and seizures which could prove fatal if not treated on time. We report a case of a 17 year old girl, who was a known case of bacterial endocarditis that presented with sudden onset deterioration of mental status, fever and dizziness. On CT scan imaging of the brain, the patient showed features of intracranial abscess and mycotic aneurysm. Since early detection, diagnosis and timely management is crucial for the prognosis of the patient, we should always opt for timely imaging in patients of infective endocarditis with neurological symptoms.