Fortuitous discovery of an anomalous connection of the coronary arteries during an urgent coronary angiography: a case report

Anomalous connection of the coronary arteries (ANOCOR) is a rare angiographic finding; although most ANOCORs are benign some are a risky condition that can lead to sudden death. Knowing their particularities is important to know how to manage them. With an angiographic prevalence averaging 1%, proximal anomalous connection of the Coronary arteries (ANOCOR) represents a diverse entity. The challenge is to distinguish the benign ANOCOR to reassure the patient from the high risk ANOCOR that may need surgical repair. We present a case of a 52-years-old man admitted to our cath lab for urgent coronary angiography after a non ST segment elevation myocardial infarction. At coronary angiography we found ectopic left anterior descending and circumflex arteries with a culprit lesion on the right non ectopic coronary artery. A computed tomography (CT) scan showed benign ectopic courses of the left anterior descending and circumflex arteries. No surgical repair was indicated.