Left ventricular dysfunction: Neither a matter of atherosclerosis nor an anomalous originated right coronary artery from left anterior descending artery

Background: abnormal separation of right coronary artery (rca) from the left coronarysystem is an extremely rare variation among coronary artery anomalies. the compressions onthe anomalous route of this artery may lead to arrhythmia, chest pain, or left ventriculardysfunction or may enhance formation of atherosclerotic plaques.case report: here, we have reported a patient presented with heart failure who had ananomalous atherosclerotic rca originating from left anterior descending artery. interestingly,neither the anomalous origin nor the atherosclerosis was the cause of the patient’s problems andshe suffered from a hypertensive cardiomyopathy.conclusion: this reminds that encountering an anomaly should not solely be interpreted asthe cause of cardiac disease.