Anomalous Origin of the Right Coronary Artery from the Left Sinus Valsalva with Coronary Ectasia

The abnormal origin of the right coronary artery from the left aortic sinus coursing between the aorta and the pulmonary trunk is a rare congenital anomaly. It may remain asymptomatic or may result in cardiac morbidity or mortality. In the past, an anomalous origin of the right coronary artery from the left sinus of Valsalva was considered a benign finding; it is now evident that this anomaly can be associated with atypical chest pain, myocardial ischemia, and sudden death. We thought that; the diagnosis of left sinus Valsalva aneurysm, described by transtorasic echocardiography and transeusophageal echocardiography, might need demonstrated advanced scanning techniques.