Intramural coronary artery as a cause of unstable angina pectoris.

A patient with an anomalous intramyocardial course of the LAD coronary artery, causing angina pectoris, is described. The patient had symptomatic relief after an aortocoronary artery bypass operation. Intramural coronary arteries may be clinically significant. In cases where medical management does not provide relief, surgical correction of the anomaly may give symptomatic improvement and improved exercise tolerance.