# Detection of Anatomical Variations and Pathological Findings of Coronary Arteries Using CT Coronary Angiography (CTCA) in Sudanese Adults in a Tertiary Hospital

## TL;DR

This study uses CT coronary angiography to detect heart artery issues in Sudanese adults, finding common stenosis patterns and anatomical variations.

## Contribution

The study provides new insights into coronary artery disease patterns and anatomical variations specific to the Sudanese population.

## Key findings

- The left anterior descending artery was most commonly affected by stenosis.
- Myocardial bridging was the most frequent congenital anomaly detected.
- Malignant RCA origin from the left cusp was the most common anatomical variation observed.

## Abstract

Background: Ischemic heart disease (IHD) is a leading cause of morbidity and mortality worldwide. Traditional diagnostic methods relied on electrocardiography (ECG) and cardiac enzyme testing, with limited accuracy. With advances in imaging, ECG-gated CT coronary angiography (CTCA) has become a reliable, non-invasive tool for risk assessment and diagnosis of coronary artery disease (CAD).

Methods: A retrospective, cross-sectional study was conducted in the radiology department of Ahmed Gasim Hospital, Sudan. Data were extracted from 95 CTCA reports between January 2020 and June 2022 using a structured 14-item questionnaire. Patient demographics, calcium scores, coronary stenosis/occlusion, congenital anomalies, and anatomical variations were analysed.

Results: The mean patient age was 51 years (range: 20-87), with male patients comprising 56.8%. Most patients (63.2%) had a calcium score of zero. Among positive scores, 17.9% were <100, 13.7% were 100-500, 2.1% were 500-1000, and 3.2% were >1000. The left anterior descending artery (LAD) was the most frequently affected artery (20.0%), followed by the right coronary artery (RCA) (13.7%), and left circumflex artery (LCX) (10.5%); left main coronary artery (LMCA) showed no stenosis. Proximal severe stenosis was the predominant pattern. Congenital anomalies were detected in six patients (6.3%), most commonly myocardial bridging. Anatomical variations were also found in five patients (5.3%), with malignant RCA origin from the left cusp being the most frequent.

Conclusion: CTCA effectively identified calcium scores, stenosis, congenital anomalies, and anatomical variations in Sudanese patients. Findings highlight a predominance of proximal severe stenosis in LAD and RCA, with myocardial bridging as the most frequent congenital anomaly and malignant RCA origin as the most common variation.