Anomalous origin of the right coronary artery: First familial cases in Asia.

Congenital coronary artery abnormalities may cause sudden death, particularly in athletes. Two siblings, aged 10 and 9 years, respectively, were diagnosed with anomalous origin of the right coronary artery on multi-detector computed tomography (MDCT). The right coronary artery arose from the left coronary cusp, and was wedged between the aorta and pulmonary artery. This was also noted on cardiac ultrasonography (UCG), but in general this might not be seen on electrocardiography at rest. Although the surgical indications are unclear in the case of unproven ischemia, early recognition of the condition may reduce risk of the cardiac events during exercise. The majority of proximal coronary artery anomalies can be screened for on UCG, and confirmed on MDCT, which yields more precise clinical details and is less invasive than angiography. This is the first report of familial cases of anomalous origin of the right coronary artery in Asia.