Anomalous Left Coronary Artery from Right Sinus of Valsalva: An Anomaly with Fatal Outcomes

Coronary anomalies are not uncommon. Patients with coronary anomalies can have a wide array of presentations varying from chest pain to sudden cardiac death. In this case, a middle-aged woman presented with atypical chest pain and was admitted for unstable angina. Cardiac catheterization identified an anomalous origin of the left coronary artery from the right coronary sinus. CT angiogram identified a high-risk course. The patient's chest pain was attributed to anomalous origin of the left coronary artery with subsequent compression due to inter-arterial course between the aorta and pulmonary trunk. She underwent successful surgical revascularization with left internal mammary artery to left anterior descending with resolution of symptoms.