Clinical Image - Volume 3 - Issue 3

Abnormal origin of the left coronary artery

El Adioui Ghita*; Ettouhami Badr

Radiology Department, Chu Ibn Sina, Rabat, Morocco.

Received Date : April 18, 2023
Accepted Date : May 24, 2023
Published Date: May 31, 2023
Copyright:© El Adioui Ghita 2023

*Corresponding Author : El Adioui Ghita, Radiology Department, Chu Ibn Sina, Rabat, Morocco.

Clinical Image

A 31-year-old female with a medical history of unexplained syncope presented with atypical chest pain. The patient has a healthy lifestyle and no risk factors. The EKG showed a sinusal rhythm with a flattened T wave in the anterior region, she then underwent a cardiovascular computed tomography and was found to have an abnormal origin of the left coronary artery from the right coronary sinus, with an inter-arterial course (figure 1). Coronary artery's anomalous origin and course are rare but can result in myocardial infarction, heart failure, arrhythmias, and sudden death [1]. The high risk of sudden cardiac arrest is due to the compression of the LCA between the great vessels, a slit ostium creating torsion or unfavorable geometry. Such anomalies constitute an important often incidental finding and have a variable prognosis, and surgical treatment for all patients is recommended [2].

Abnormal LCA origin and course
Figure 1:
Cardiac computed tomography showing the abnormal origin of the left coronary artery from the right coronary sinus as a separate vessel, with an inter-arterial course. (AP: pulmonary artery. AO: aorta, LCA: Left coronary artery).


  1. Ferreira AFP, Rosemberg S, Oliveira DS, Araujo-Filho JAB, Nomura CH. Anomalous origin of coronary arteries with an interarterial course: pictorial essay. Radiologia brasileira. 2019; 52(3): 193-197.
  2. Mahesh Anantha Narayanan, Christopher DeZorzi, Abhilash Akinapelli, Toufik Mahfood Haddad, Aiman Smer, Janani Baskaran, et al. Malignant Course of Anomalous Left Coronary Artery Causing Sudden Cardiac Arrest: A Case Report and Review of the Literature. Case Reports in Cardiology. 2015; 2015: 4.