Left circumflex coronary artery is continuing to form the right coronary artery – Angiographic imaging

A Forty-six year old previously asymptomatic diabetic and not hypertensive female medical practitioner was admitted with a sudden onset of exertional chest discomfort that subsided spontaneously without any medication. Clinically she is anxious and the ECG, X-ray chest, echocardiography, blood chemistry and other parameters were normal. She achieved 9.2 METs in Treadmill exercise test at Bruce protocol stage 3 and developed rapid upsloping of ST segment with sweating and chest discomfort at a heart rate of 175 bpm in peak exercise which rapidly returned to normal in the immediate recovery period and symptom free. Invasive coronary angiography was done which is as follows.