Aberrant left main coronary artery (ALMCA) arising from the right sinus with interarterial course
Dyspnea and mild chest pain on exertion. Routine echocardiogram performed by pediatric cardiologist raised suspicion of coronary anomaly.
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Left main artery arising from the right anterior sinus (ALMCA) with an interarterial course: mild stenosis is seen all along its course between pulmonary arterial trunk and aorta. The common left main artery then trifurcates into a left marginal artery, the anterior interventricular artery, and the circumflex artery.
Right coronary dominance.
In patients with this condition, there is a marked increased risk of sudden cardiac death and myocardial infarction upon exertion.