Abstract
An ectopic coronary artery is observed in 0.05–0.1% of angiographic series, may be of tangential origin or proximal endocardial pathway, may result in a slit hole that interferes with flow, and is associated with sudden death.
Highlights
Congenital anomalies and variations of the coronary arteries (CAA) are present at birth but can remain symptomatically silent for life, being discovered accidentally during interventional radiological procedures or whose discovery is prompted by cardiac chest pain
Benign variations include 1) origination of the left anterior descending and left circumflex arteries from the left sinus of Valsalva (LSV), 2) the circumflex artery originating from the right coronary artery or right sinus of Valsalva (RSV) and 3) ectopic origin of the right coronary artery from the ascending aorta (1)
The most common malignant variation of the coronary arteries is the ectopic origin of the right coronary artery from the LSV, which demonstrates a single coronary artery, beginning from the aortic trunk via a single coronary arterial ostium, acting as the primary blood supply to the heart (2)
Summary
Congenital anomalies and variations of the coronary arteries (CAA) are present at birth but can remain symptomatically silent for life, being discovered accidentally during interventional radiological procedures or whose discovery is prompted by cardiac chest pain. The most common malignant variation of the coronary arteries is the ectopic origin of the right coronary artery from the LSV, which demonstrates a single coronary artery, beginning from the aortic trunk via a single coronary arterial ostium, acting as the primary blood supply to the heart (2). A coronary angiogram was performed using the Judkin’s catheterisation technique, which revealed an ectopic origin of the right coronary artery from the LSV. Following this diagnosis, the patient was referred to surgery for a coronary artery bypass graft (CABG), in which the right coronary artery was found to originate between the aorta and pulmonary trunk. Following up 7 days postoperatively, no further episodes of chest pain or syncope were reported by the patient
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