Angina and sudden cardiac death caused by anomalous right coronary artery origin from above the left coronary cusp

Anomalous right coronary artery (RCA) origin, an extremely rare but well described condition and cause of myocardial ischemia, arrhythmia, and syncope, has recently become recognized as a cause of sudden cardiac death in the young. [1] In contrast to the previously reported cases of RCA anomalies, we report this unique case of angina and sudden cardiac death caused by anomalous RCA origin from above the left coronary cusp. It is unique in that it occurred in a female, had a late onset of presentation, and was associated with no other cardiac abnormalities. The patient underwent successful revascularization.