Solitary right coronary artery aneurysm with anomalous origin of left coronary artery

A 48-year-old male patient was referred to radiology department for coronary computerized tomography (CT) angiography. He gave history of atypical chest pain. The electrocardiogram and echocardiogram were normal. There was no past medical history of hypertension, hyperlipidemia, and diabetes mellitus. Coronary CT angiography showed presence of fusiform aneurysm involving proximal right coronary artery measuring 11× 9 mm (Figs. 1a and 2a). There was evidence of mild diffuse atherosclerotic disease involving the right coronary and the left anterior descending arteries without any area of significant stenosis. The left main coronary artery was seen arising from proximal ascending aorta (Figs. 1b and 2b) rather than from the aortic sinus. Hence, imaging diagnosis of the fusiform right coronary artery aneurysm with anomalous origin of the left main coronary artery was given. The cause for this aneurysm was presumed to be atherosclerotic since the patient was adult and there was evidence of atherosclerotic disease involving the right coronary (Fig. 2a) and left anterior