Congenital coronary artery anomaly demonstrated by three dimensional 16 slice spiral CT angiography

A 57 year old man with multiple risk factors for coronary artery disease presented with exercise related chest pain. An x ray angiogram revealed no coronary atherosclerosis but, rather, an anomalous left coronary artery course. Whether the anomalous coronary artery travelled a clinically benign course posterior to the aorta or a potentially lethal course between the aorta and pulmonary trunk, however, …