An interesting and unusual coronary artery anomaly.

Cardiac CT angiography utilized in the emergency room for triage of low-to-intermediate risk chest pain on occasion identifies unexpected abnormalities. In this case, multiple coronary anomalies existed in the same patient. Images and clinical decision making are discussed in this presentation. Coronary anomalies are being recognized with increased frequency due to increasing use of this modality in the evaluation of chest pain. The clinical implications of these findings are not always clear.