case_images: PMC4784187_01
case_images: Coronary angiography: Total occlusion of right coronary artery (RCA) and left circumflex artery. Left anterior descending artery originating from RCA
case_images: JOACP-32-103-g001.jpg
case_images: PMC4784187_01_JOACP-32-103-g001.jpg
case_images: F1
case_images: Two months ago, a detailed cardiac work up of the patient had been done wherein a coronary angiogram revealed anomalous origin of the LAD from RCA and absent left main coronary artery (Figure 1).
case_images: Computed tomography coronary angiography: Common ostium for right coronary artery (RCA) and left anterior descending artery; absent left main artery. Left circumflex artery short in length and significantly narrow in caliber; completely blocked RCA in proximal segment due to dense calcification
case_images: JOACP-32-103-g002.jpg
case_images: PMC4784187_01_JOACP-32-103-g002.jpg
case_images: F2
case_images: Thallium scan also showed LVEF of 25% at rest tomography angiography showed a common ostium for RCA and LAD (Figure 2).