Symptomatic anomalous right coronary artery originating superior to the left aortic sinus with interarterial course in a young adult. Diagnosis with multislice computed tomographic coronary angiography

Abstract

Anomalous origination of a coronary artery from the opposite (improper) aortic sinus with interarterial course comprises the group of coronary anomalies with the greatest risk for sudden cardiac death (SCD) in the young. SCD in such settings is consistently related with exercise and driven by ischemia. The proximal ectopic vessel is intussuscepted at the aortic wall and such an anatomy has been documented to be the culprit one. We present a 26-year-old male patient with exercise-induced angina and syncope due to an anomalous right coronary artery, which originated from the tubular ascending aorta superior to the left aortic sinus and followed an interarterial course. Diagnosis was reached with multislice computed tomographic (MSCT) coronary angiography. This case highlights the utility of MSCT to depict the ectopic coronary artery origin and course as