Two patients with normal and abnormal coronary arteries

A 63-year-old man with type 2 diabetes and hypertension presented to the outpatient clinic with atypical symptoms. A 64-slice multislice computed tomography (MSCT) coronary angiogram was performed, which showed normal coronary arteries, as indicated by the 3-dimensional (3D) volume rendered reconstruction shown in the Figure (A). Accordingly, no further imaging was performed. A year later, the patient was contacted by telephone and reported that he was in good condition without having experienced any coronary events.

Multislice computed tomography coronary angiography was performed on a 73-year-old patient with a history of inferolateral myocardial infarction and subsequent stenting of the right coronary artery. The scans revealed extensive atherosclerosis in all 3 coronary arteries, which can be seen on the 3D volume rendered reconstruction in the Figure (B; arrowheads indicate atherosclerotic changes in the coronary arteries). Despite optimal treatment, the patient presented to the outpatient department 1 year later with an acute anterior infarction.

Figure. Normal coronary arteries, as indicated by 3-dimensional volume rendered reconstruction, in

a 63-year-old man (A). Extensive atherosclerosis in all 3 coronary arteries in a 73-year-old patient

(B; arrowheads indicate atherosclerotic changes in the coronary arteries). AL indicates anterolateral

branch; IM, intermediate branch; LAD, left anterior descending coronary artery; LCx, left circumflex

coronary artery.