Anomalous right coronary artery arising from left coronary cusp with coexisting valvular heart disease

We report an unusual case,a 50 year old female with an abnormal right coronary artery originating from the left coronary cusp. the patient,who had a history of hypertension presented with chest pain and shortness of breath to the emergency department. she was diagnosed with ischaemic heart disease (ihd) and had hypertension as one of the coronary risk factor. echocardiography revealed poor progression of r waves. she was scheduled for echocardiography thereafter which revealed severe aortic stenosis with aortic root dilatation. the patient was discharged due to absence of any complications or other anomalies. this case is unique because of the simultaneously presenting valvular pathology,along with the anomalous origin of the right coronary artery which was detected,as an incidental finding,during coronary angiography. © 2016,pakistan medical association. all rights reserved.