eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2020-03-19 8 5 134 136 10.12691/ajmcr-8-5-6 AJMCR2020856 article Jonathan Francois 1 Pramod Theetha Kariyanna 1 Amog Jayarangaiah 2 Tobin Matthew 2 Isabel M McFarlane Isabel.McFarlane@downstate.edu 2 Division of Cardiovascular Medicine and Department of Medicine, State University of New York Health Sciences University- Downstate Medical Center, Health + Hospitals/Kings County, Brooklyn, N.Y., U.S.A-11203 Trinity School of Medicine, 925 Woodstock Road, Roswell, GA 30075, U.S.A. Coronary artery anomalies are diagnosed in approximately 1% of patients who undergo coronary angiography (CAG). Several anomalies are life threatening but are generally asymptomatic and clinically insignificant. Nonetheless, proper recognition and adequate visualization is necessary for proper medical management, especially in patients undergoing percutaneous coronary intervention or cardiac surgery. In this report, a 73-year-old female was admitted for NSTEMI. Coronary angiography revealed a stenotic right coronary artery and separate ostium of the left circumflex artery and left anterior descending artery from the left Valsalva sinus. The patient was treated with percutaneous coronary intervention of the RCA lesion. http://pubs.sciepub.com/ajmcr/8/5/6/ajmcr-8-5-6.pdf dual ostium absence of left main artery angina accelerated atherosclerosis coronary angiography