Anomalous right coronary artery from the left coronary sinus with an interarterial course: is it really dangerous?

Anomalous origin of the right or left coronary artery from the contralateral sinus of Valsalva is often asymptomatic, but many patients, particularly young ones, present with sudden death or myocardial ischemia without symptoms. The mechanism of sudden death in this entity is unclear and has not been fully evaluated. These anomalies are rare, and many cardiologists and radiologists are unfamiliar with them. Surgical repair is recommended, especially with anomalous origin of the left coronary artery (LCA). However, there is controversy concerning the treatment of anomalous right coronary artery (RCA) with interarterial course due to its relatively high incidence and the fact that it leads to few, if any, clinical problems.