A Rare Coronary Artery Anomaly: Origin of All Three Coronary Arteries from the Right Sinus of Valsalva

Left anterior descending (LAD) artery and left circumflex (LCx) coronary artery originating separately from the right sinus of valsalva is exceptionally rare and very few cases have been reported in the literature. Congenital coronary artery anomalies are generally incidental, uncommon, and asymptomatic. Some can cause severe potentially life-threatening symptoms such as myocardial ischemia and sudden cardiac death. The aberrant vessels that pass between the aorta and the pulmonary trunk pose a risk of sudden cardiac death, particularly if the vessel supplies the left coronary artery network. The electrocardiographically gated multi-detector computed tomography (MDCT) allows accurate and non-invasive depiction of coronary artery anomalies including origin, course, and termination. We report here a rare case of all three coronary arteries separately originating from the right coronary sinus, which was detected with MDCT.