Anomalous left main coronary arterial origin
Shortness of breath with anginal symptoms with positive TMT
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MDCT coronary angiography post processed images (MIP and VRT) showing RCA and LMCA arising from right coronary cusp with separate ostia with retro aortic course of long LMCA before trifurcating.
An aberrant origin of left main coronary artery from right coronary aortic sinus is a rare anomaly, found in 0.0024% to 0.02% of the population.
The course of the anomalous LMCA can be of 4 types
Interarterial course that is between aorta and pulmonary artery is considered malignant and has been associated with ischemic events and sudden death.
MDCT can clearly depict origin and course of involved coronary noninvasively.
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