Coronary computed tomography angiography findings in young adults

Abstract

Objective: Various clinically significant cardiovascular anomalies of coronary arteries that are not associated with atherosclerosis have been previously described. This study aimed to evaluate coronary anomalies or variations on coronary computed tomography angiography (CCTA) images in patients aged under 40 years and to compare them with clinical findings, thereby contributing to the literature. Material and Methods: Patients under 40 years who underwent CCTA with current clinical indications between 2015 and 2018 were included in the study. The scans were performed using a 128-slice CT device and electrocardiography triggering in different phases. During the examination, 35%–75% of phases were frequently evaluated although the percentage varied according to the heart rate. Outlet, course, internal structure and termination anabolites, and pathologies, as well as anatomical dominance of coronary arteries, were evaluated. However, unlike this classification, myocardial bridges (MBs) were specified as variations. Coronary artery disease reporting and data system (CAD-RADS) was used to standardize stenosis rates in the walls of coronary arteries and their lumen. Results: Of the 927 CCTAs taken over a 3-year period, 188 belonged to patients under 40 years. The study included 156 men and 32 women with a mean age of 34.99±4.78 years. In the comparison between the patients with and without chest pain in terms of the presence of CAD-RADS 1 and above, a statistically significant higher rate of CAD was found in the group with chest pain (p<0.05). Abnormal cardiac findings and variations were detected in 103 patients (55%), including 16 with multiple abnormalities. Of these 103 patients, 49 (26%) had MBs. Conclusion: Considering the presence of anomalies and variations in young adults with cardiac complaints, the reasons for the ambiguous symptoms may become clear with the use of noninvasive methods, such as CCTA. Thus, cardiovascular anomalies that may cause serious and acute events in the future, including sudden death can be detected in advance, allowing early interventions to be undertaken.