An anomalous right coronary artery (RCA) arising from the mid left anterior descending artery (LAD) is extremely rare and has been described as a variant of single coronary artery anomaly in the past. We report a case of an anomalous, non- dominant RCA arising from the mid LAD in a patient who was investigated for complaints of chest pain that had both typical and atypical components to its character. Afterwards a normal stress nuclear perfusion study excluded the possibility of this anomaly as an aetiology of myocardial ischaemia.
click here to reroll the summary

In a 20-year-old female patient a 64-slice computer tomography was performed because of unexplained ECG changes. Cine-loops were obtained from a sequence of 10 ECG-gated phases of the cardiac cycle. Both cine-loops and reconstructed images suggested a coronary cameral fistula between the left coronary artery and the right ventricle via multiple thin channels. Conventional coronary angiography confirmed this diagnosis. Because of the nature of the shunt, both percutaneous and surgical closure were excluded. The conclusion being that 64-slice spiral computed tomography can play a role in functional and anatomical noninvasive imaging of coronary fistulas
click here to reroll the summary

A 68 year-old female underwent PCI to her proximal LAD with implantation of 2 Cypher stents. At the 6-month angiography the stents were widely patent, with good apposition noted on IVUS. At the 2 year follow-up, the patient remained well, however there was evidence of marked positive vascular remodelling noted on IVUS. We suggest that late vascular remodelling with consequent stent malapposition may be an important cause of stent thrombosis and myocardial infarction after drug-eluting stent implantation.
click here to reroll the summary