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Radiology
Coronary Artery Anomalies and Disease
Built from Fundamentals of Diagnostic Radiology
What’s inside
5 sections · 155 slides
Overview
- What this topic covers
Coronary Artery Anatomy
The vessels, their branches, and normal variants
- How the coronary arteries are imaged
- Why normal variants matter
- The coronary ostia and sinuses of Valsalva
- Normal coronary ostial anatomy
- Left main coronary artery
- Normal left main coronary artery anatomy
- Left anterior descending artery
- Left anterior descending artery segmentation
- Septal and diagonal branches of the LAD
- Septal and diagonal branches of the LAD
- Left circumflex artery
- LAD and LCx coronary artery anatomy
- Ramus intermedius
- Ramus intermedius
- Right coronary artery
- Right coronary artery anatomy
- Right coronary artery territories
- Right coronary artery territories and branches
- Coronary dominance
- Posterior descending artery and dominance
- Left dominance and codominance
- Posterior left ventricular branch
- Conus branch
- Anatomy of the conus artery
- Sinoatrial nodal branch
- Sinoatrial nodal branch anatomy
- Atrioventricular nodal branch
- Atrioventricular nodal branch anatomy
Coronary Artery Anomalies
Benign and malignant variants of origin, course, and termination
- Coronary anomalies overview
- Classifying coronary anomalies
- Benign anomalies of origin
- Absent left main coronary artery
- Absent left main coronary artery
- High origin of a coronary artery
- High origin of the right coronary artery
- Retroaortic course
- Retroaortic course
- Prepulmonic (precardiac) course
- Prepulmonic course
- Septal (intramyocardial) course
- Septal course of the left anterior descending artery
- Origin from the noncoronary sinus
- Coronary artery from the noncoronary sinus
- Interarterial course
- Why an interarterial course is dangerous
- Interarterial course of the right coronary artery
- Interarterial course of the left main coronary artery
- Interarterial course — management
- ALCAPA — left main from the pulmonary artery
- ALCAPA in infancy
- ALCAPA in an infant
- ALCAPA in adults
- ALCAPA in an adult
- Single coronary artery
- Single right coronary artery
- Ostial atresia
- Ostial atresia
- Myocardial bridging
- When myocardial bridging causes symptoms
- Myocardial bridging
- Intracavitary course
- Intracavitary course of the right coronary artery
- Split (double) coronary artery
- Extranumerary coronary arteries
- Coronary artery fistula
- Coronary artery fistula
Coronary Artery Disease
Calcification, plaque, stenosis, and the role of CT and MRI
- Coronary artery disease and CTA
- When to use coronary CTA
- Coronary artery calcium screening
- What the calcium score means
- How calcium scoring is done
- Calcium scoring for future cardiac events
- Plaque types
- Stable versus vulnerable plaque
- How a vulnerable plaque causes events
- Positive remodeling
- Positive remodeling
- Low-attenuation plaque and the napkin-ring sign
- Napkin-ring sign
- Coronary stenosis
- 98%
- Measuring stenosis
- Semi-automated stenosis measurement
- Degrees of stenosis and their meaning
- Degrees of stenosis by CTA
- Subendocardial perfusion defects
- Subendocardial hypoperfusion
- Left main territory myocardial infarct
- Perfusion CT and CT-FFR
- Myocardial perfusion imaging and CT-FFR
- Coronary CTA in acute chest pain
- Coronary CTA in acute chest pain
- MRI of the coronary arteries (coronary MRA)
- Coronary MR angiography
- Four goals of cardiac MRI in ischemic disease
- MRI wall motion and coronary territories
- Transmural LAD territory infarct with apical aneurysm and thrombus
- Transmural LAD territory infarct with apical aneurysm and thrombus
- Left circumflex territory infarct
- Edema, perfusion, and delayed enhancement
- Subacute RCA infarct with a small posterior left ventricular branch
- Subacute RCA infarct with a large posterior lateral ventricular branch
- Late gadolinium enhancement and viability
- Microvascular obstruction
- MRI stress imaging for ischemia
- Cardiac MRI stress test
Treatment and Complications
Stents, bypass grafts, aneurysms, dissection, and post-infarct rupture
- Coronary stents
- Stent evaluation using coronary CTA
- Coronary artery bypass grafts
- Bypass graft assessment
- Saphenous vein grafts and complications
- Saphenous vein graft occlusions
- Saphenous vein graft aneurysm
- Saphenous vein graft pseudoaneurysm
- Coronary artery aneurysm
- Kawasaki disease aneurysms
- Coronary artery aneurysms
- Coronary artery pseudoaneurysm
- Coronary artery pseudoaneurysm
- Coronary artery dissection — causes
- Type A dissection and the coronary arteries
- Type A aortic dissection extending into the LAD
- Spontaneous coronary artery dissection (SCAD)
- Spontaneous coronary artery dissection
- Mechanical complications after MI
- Mechanical complications after MI
- True versus pseudoaneurysm of the left ventricle
- Left ventricular pseudoaneurysm versus true aneurysm
- Left ventricular pseudoaneurysm
- True left ventricular aneurysm
- Ventricular septal rupture
- Ventricular septal rupture
- Papillary muscle rupture
- Papillary muscle rupture
- Cardiac findings on routine CT
- Cardiac findings on nongated CT
- Key takeaways
- References
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- References (continued)
- Brant and Helms' Fundamentals of Diagnostic Radiology