Myocardial ischemia caused by a coronary anomaly left anterior descending coronary artery arising from right sinus of Valsalva

We present the case of a patient in anomalous origin of the left anterior descending coronary artery that caused myocardial ischemia and led to positive myocardial scintigraphic results. Coronary angiography showed that the left anterior descending coronary artery arose from the right coronary ostium–an anomaly that has been associated with chest discomfort–without atherosclerotic lesions. Left circumflex artery and the diagonal branches were arising from the left main coronary artery and the whole coronary tree were free of atherosclerosis.