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What Does This CT Scan Report Indicate?

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Posted on Thu, 25 May 2017
Question: I am 43 yo male and have done a CT scan of heart. The finings of anomolous origin of RCA is included. Please advise? I went to carfiologist who did stress test and said heart is ok. It is origin of RCA from left side of sinus of valsava. Course is between aortic root and rvot
doctor
Answered by Dr. Rishu Saxena (35 minutes later)
Brief Answer:
Right sided is more common than left and usually, no complication is assisted

Detailed Answer:
Hello,
Thank you for choosing this forum to ask your query.
I am Dr. Rishu, a cardiologist and would be addressing your query.

I have gone through your details and I appreciate your concern.

Normally the right coronary artery (RCA) is an artery originating above the right cusp of the aortic valve, at the right aortic sinus. It travels down the right atrioventricular groove, towards the crux of the heart. It branches into the posterior descending artery and the right marginal artery.

Anomalous origin of the right coronary artery from the contralateral sinus of Valsalva is often asymptomatic, but many patients, particularly young ones, present with sudden death or myocardial ischemia without symptoms. The mechanism of sudden death in this entity is unclear and has not been fully evaluated. These anomalies are rare, and many cardiologists and radiologists are unfamiliar with them. Surgical repair is recommended only with anomalous origin of the left coronary artery (LCA). However, there is controversy concerning the treatment of anomalous right coronary artery (RCA) with intraarterial course due to its relatively high incidence and the fact that it leads to few clinical problems.

As per the standard trials-

"sudden death is extremely rare in asymptomatic patient with anomalous RCAs, and there is no sudden death in children under 10 years of age or adults over 30 years of age so the best policy is to leave it surgically corrected"

So the take home message is that chances of complication with Right coronary artery are very low hence it should not be disturbed as performing surgery has its own mortality rates.

As stress test is ok your heart is good however for anomalous origin my advice would be not to panic and enjoy life. The probability of the problem with Right sided anomaly is very low and rare.

Let me know if I can assist you further.

Thanks.



Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Rishu Saxena (1 hour later)
Thanks Doctor. So doing 30 mins on the treadmill daily is safe for me? Normally pulse is between 125 to 148 during the workout
doctor
Answered by Dr. Rishu Saxena (2 hours later)
Brief Answer:
Follow-up

Detailed Answer:
Hi again,

No, try to avoid very heavy workouts.
Normal treadmill stress etc and any heavy stress workout should also be avoided.
Try to do only mild to moderate exercises just to prevent any sudden cardiac collapse.

Regards.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Rishu Saxena (13 hours later)
Hi Doctor,

Thanks for clarifying. However it is slightly scary that i should prevent Treadmill as it is a source of good exercise for me. What should I consider as moderate exercise? To keep pulse rate in a certain range? Or is it duration
doctor
Answered by Dr. Rishu Saxena (4 hours later)
Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
Its not like that you can't walk on treadmill but try not to push things beyond your limits.
Walk on tread mill for 10 minutes then take a small break give some rest to your heart and again do the same.
Swimming is the best exercise and should be done daily for 30 minutes.
Mild to moderate walking should also be done. Cycling is god for you.
Just don't over exert yourself that's it. Otherwise you can do anything.
pulse rate should not exceed 85% of 220-your age for your own safety.

Regards and wish you a great life.
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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What Does This CT Scan Report Indicate?

Brief Answer: Right sided is more common than left and usually, no complication is assisted Detailed Answer: Hello, Thank you for choosing this forum to ask your query. I am Dr. Rishu, a cardiologist and would be addressing your query. I have gone through your details and I appreciate your concern. Normally the right coronary artery (RCA) is an artery originating above the right cusp of the aortic valve, at the right aortic sinus. It travels down the right atrioventricular groove, towards the crux of the heart. It branches into the posterior descending artery and the right marginal artery. Anomalous origin of the right coronary artery from the contralateral sinus of Valsalva is often asymptomatic, but many patients, particularly young ones, present with sudden death or myocardial ischemia without symptoms. The mechanism of sudden death in this entity is unclear and has not been fully evaluated. These anomalies are rare, and many cardiologists and radiologists are unfamiliar with them. Surgical repair is recommended only with anomalous origin of the left coronary artery (LCA). However, there is controversy concerning the treatment of anomalous right coronary artery (RCA) with intraarterial course due to its relatively high incidence and the fact that it leads to few clinical problems. As per the standard trials- "sudden death is extremely rare in asymptomatic patient with anomalous RCAs, and there is no sudden death in children under 10 years of age or adults over 30 years of age so the best policy is to leave it surgically corrected" So the take home message is that chances of complication with Right coronary artery are very low hence it should not be disturbed as performing surgery has its own mortality rates. As stress test is ok your heart is good however for anomalous origin my advice would be not to panic and enjoy life. The probability of the problem with Right sided anomaly is very low and rare. Let me know if I can assist you further. Thanks.