Presentation
Chest pain.
Patient Data
A catheter angiogram shows a single coronary artery, dividing into a normal right coronary artery with an anomalous left coronary artery course. A "hammock sign", where the left coronary artery has a downward course, suggests that the left coronary has a benign, subpulmonic course.
The coronary CT angiogram confirms a benign, subpulmonic course of the anomalous left coronary artery, well seen in the sagittal plane. Normal right coronary artery course, no obstructive disease.
Case Discussion
Although this case superficially resembles a malignant left coronary artery course, where the vessel passes between the aortic and pulmonic valves, the anomalous artery in this case has a subpulmonic course not associated with sudden death. The subpulmonic course is best recognized in the sagittal plane.
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