Anomalous Origin of the Right Coronary from the Left Coronary Sinus: How to approach?

Coronary artery anomalies (CAAs) are characterized by a changed vessel origin, path, or structure. It is a rare condition, present in approximately 1% of the general population. These anomalies include the anomalous aortic origin of a coronary artery (AAOCA), which can travel retroaortic, subpulmonic, prepulmonic, and inter-arterial courses.

In general, these abnormalities remain asymptomatic until adulthood, being incidental findings on complementary tests or necropsy. However, they can also cause angina, syncope, ischemia, arrhythmias, or sudden death.^, Sudden death can be the first presentation of this pathology in young athletes, representing the second leading cause of death in this group.