Multidetector row computed tomographic findings in a patient with anomalous origin of the right coronary artery from the left sinus of Valsalva.

Anomalous origin of the right coronary artery (RCA) is a rare congenital anomaly, which may cause myocardial ischemia and sudden death. However, the causes of myocardial ischemia remain uncertain. Multidetector row computed tomography (MDCT) was performed in a 22-year-old woman who had exercise-induced myocardial ischemia. MDCT revealed a small orifice of the RCA in the left sinus of Valsalva, separate from the left main coronary artery, an acute-angled takeoff from the aorta, an intramural course of the proximal portion within the aortic wall, and a course between the great vessels. Three-dimensional virtual angioscopy also depicted a small orifice.