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Coronary Artery DOMINANCE
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Coronary Artery DOMINANCE

I was reviewing the medical report for a heart catherization that I underwent a year ago at an out-of state medical facility. It reads that "Coronary artery dominance is right."  Does that mean that my right coronary artery is dominant over the left one? How is that possible?  Since the left coronary artery is considered the main heart artery, why wouldn't it always be the dominant artery?
   The results of my angiogram were relatively benign, showing a small "single discrete lesion" in the proximal right coronary artery. The formal diagnosis is "1 coronary artery atherosclerosis"; however, the report adds that "The RCA lesion may have been catheter spasm, which did not entirely resolve with IC NTG."  Why couldn't the doctors differentiate between a pre-exiting atherosclerosis obstruction and a spasm (a clot?)  caused by insertion of the catheter?  The procedure was performed at one of the most prestigious U.S. medical institutions.
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Dear Jo Ann

Coronary artery dominance refers to which artery supplies the posterior part of the heart. In most people it is the right coronary artery. Spasm refers to constriction of the blood vessel, not clot. It can occur due to the catheter itself, especially in the right coronary artery. It can be difficult to differentiate spasm from true disease in the best of hands. This is why tests should only be done when they are truly necessary in the first place, as results can be ambiguous.

I hope this has been useful. I wish you the best of luck. Feel free to write back.

Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
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