A young male with history of acute chest pain. Cardiac CT was performed. What is your diagnosis?  
 Click here for Bigger Picture
Click here for Bigger Picture
Pic 1 
Pic 2
 ________SCROLL FOR ANSWER__________




Left Coronary Artery (LM) arising from right coronary cusp.

This is type B (where it runs between aortic root and Right ventricular
outflow track (RVOT)) . It is Class III, clinical relevance: 'severe' type of
anomaly. It can give rise to angina and can be a cause of sudden death ,
due to compression of LM between aortic root and RVOT.

Dr Hemant Telkar
Jupiter Scan Centre, Mumbai