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Supreme dominance of right coronary artery in a patient with typical angina
  1. A Shaheer Ahmed1,
  2. Nirmal Ghati1,
  3. Gautam Sharma1 and
  4. Amarinder Singh Malhi2
  1. 1 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
  2. 2 Cardiovascular Imaging and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Professor Gautam Sharma, drgautamsharma12{at}


A 50-year-old woman presented to our hospital with Canadian Cardiovascular Society grade III angina of 4 months duration. Coronary angiography of the patient showed the absence of left main coronary artery from the left coronary sinus. There was a single right coronary artery (RCA) with a super dominant course from right coronary sinus. It also showed a left main coronary and left anterior descending artery arising separately from proximal RCA, with retroaortic and prepulmonic course, respectively. There was another independently arising small septal branch from the proximal RCA that supplied the proximal interventricular septum. The patient was managed with optimal medical therapy and had symptomatic relief.

  • radiology (diagnostics)
  • cardiovascular medicine
  • clinical diagnostic tests

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  • Contributors ASA: conception and design, acquisition of data and analysis and interpretation of data. NG: agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved. GS: final approval of the version published. ASM: three-dimensional reconstruction of CT coronary angiogram.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.