Role of computed tomography coronary angiography in the management of coronary anomalies

Congenital abnormalities of coronary arteries are an uncommon cause of sudden cardiac death and are difficult to detect at coronary angiography. We describe two patients with acute coronary syndrome and non-occlusive coronary artery disease in which a 64-multidetector computed tomography (MDCT) coronary angiography showed the presence of a malignant coronary anomaly. Sixty-four-MDCT with the possibility of 3D reconstructions allows for easier diagnosis of coronary anomalies and provides essential details necessary for operative intervention.