Abstract

The abnormal origin of the right coronary artery from the left aortic sinus coursing between the aorta and the pulmonary trunk is a rare congenital anomaly. It may remain asymptomatic or may result in cardiac morbidity or mortality. In the past, an anomalous origin of the right coronary artery from the left sinus of Valsalva was considered a benign finding; it is now evident that this anomaly can be associated with atypical chest pain, myocardial ischemia, and sudden death. We thought that; the diagnosis of left sinus Valsalva aneurysm, described by transtorasic echocardiography and transeusophageal echocardiography, might need demonstrated advanced scanning techniques.

Highlights

  • Coronary artery anomalies are a relatively rare condition

  • The right coronary artery which arise from the left sinus valsalva and courses between the ascending aorta and pulmonary artery with proximal ectasia demonstrated by multi detector computerize tomography (MDCT) heart angiography (Figure 2 (a) and (b))

  • Mechanical compression of the right coronary artery by the great vessels is the usual explanation, because the right coronary artery generally courses between the aorta and the pulmonary artery to its normal position

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Summary

Introduction

Coronary artery anomalies are a relatively rare condition. The clinical presentation of coronary artery anomalous is variable, ranging from being asymptomatic to symptoms of syncope, unstable angina, myocardial ischemia and sudden death. The incidence of anomalous coronary arteries has been reported to be approximately 1% to 2% [1]. Variations in the origin and/or course of anomalous coronary arteries are well documented in the literature but in this case, “interestingly” there was an anomalous right coronary artery arising from the left coronary sinus with proximal ectasia

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