Differential diagnosis, investigations, and treatment
The decision was made to proceed with a TTE and a CTA. The CTA revealed
an intercoronary communication between the LAD and the RCA in the
mid-segment, both of which were tortuous and dilated (Figures
1,2) . They present an “arched” morphology by merging before
draining into the basal third of the free wall of the RV. Additionally,
there was coronary ectasia in the LMCA.
A multidisciplinary team, including the hemodynamics department, decided
for conservative management and a 6 month follow-up was scheduled along
with a TTE evaluation.