CTICasesAnomalous Right Coronary Artery with Myocardial Bridging
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Imaging findings
Coronary CT angiography in a 43-year-old male with chest pain reveals a non-dominant right coronary artery originating from a high/anomalous position and demonstrating a very long segment of myocardial bridging. Focal calcification is noted at the anomalous origin (the positive classification sign).
Key takeaways
Myocardial bridging occurs when a segment of a coronary artery courses tunneled through the myocardium rather than epicardially, potentially leading to systolic compression and ischemia. While anomalous coronary origins and myocardial bridging are congenital, identifying long bridged segments of non-dominant vessels is important for determining appropriate clinical management, as stenting or unbridging such long segments can be technically challenging and carry risks of mechanical disruption.
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