ABSTRACT
BACKGROUND: Congenital coronary artery anomalies are rare and are usually an incidental ?nding. The incidence of coronary anomalies was reported as 1.3% in a large number of patients undergoing coronary angiogram1. In this report we present a patient with a malignant right coronary artery (RCA) originating from left coronary sinus CASE REPORT:A 52 year old male came to cardiac OPD in view of ?tness for cataract surgery. He does not have any signi?cant cardiac history or symptoms. Coronary angiogram revealed Anomalous coronary artery arising from left coronary sinus with critical 99% lesion in the Mid RCA. The patient was taken up for Percutaneous transluminal coronary angioplasty and the Mid RCA lesion was addressed. CONCLUSION:The treatment plan for people with Malignant RCA should be based on an interdisciplinary decision made between the treating physician, patient, cardiovascular imaging experts, cardiologists and heart surgeons depending on symptoms, age, anatomic features of ACAOS and ischaemic testing.